Steve Blank: The "Lean Startup" Movement has Finally Reached Health Care
Meet the Man Leading California's $3M 'Precision Medicine' Initiative
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So far, he's founded or worked at eight startups that run the gamut from video games to supercomputers.\u003c/p>\n\u003cp>Until recently, there was only one sector that he wouldn't touch: Health care. Blank said he did not see a way to apply his entrepreneurial methods to medicine, a sector that he viewed as slow to innovate.\u003c/p>\n\u003cp>Blank's ideas about startups and entrepreneurship are known around the world. Along with his former student from UC Berkeley Eric Ries, Blank is a leading proponent of the \"Lean Startup\" movement, which directs new companies to allocate their resources as sparingly as possible -- a challenging feat for many health care companies. \u003c/p>\n\u003cp>Blank has shared this approach with thousands of would-be entrepreneurs at top universities like Stanford, New York University, University of California, San Francisco and Imperial College London.\u003c/p>\n\u003cp>He teaches students to take a customer-centric approach by interviewing people about their needs, developing a basic prototype, testing it in the market, and then returning to the drawing board. Rinse and repeat. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In the wake of the Affordable Care Act and other health reforms, Blank has now changed his tune about health care. He now envisions a way for clinicians, doctors and researchers to bring new medical technologies to market using lean startup methods. This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>What was your turning point in thinking that your approach was relevant for health care?\u003c/strong>\u003c/p>\n\u003cp>I wrote in several books that the lean startup methods would work everywhere -- except for Life Sciences. As I saw it, there was this notion among scientists that there's no need to leave the building until the product works for everyone and everything. But I got a call from UCSF a few years ago. They said, 'Steve, we need you to put on a class. Whether it's digital health or therapeutics -- all of our students could benefit from a customer development process.' I decided to give it a shot.\u003c/p>\n\u003cp>\u003cb>How did you decide to structure the class?\u003c/b>\u003c/p>\n\u003cp>We had about 70 teams apply for about 20 spots. These student 'principal investigators,' who are typically researchers or surgeons, took the class and they picked a grad student and an industry mentor. We ended up splitting the class up into four categories: digital health, therapeutics, diagnostics and medical devices. We talked about everything from making improvements to existing products to innovations that had never existed before. The class itself was a prototype of sorts.\u003c/p>\n\u003cp>\u003cstrong>What did you learn along the way? \u003c/strong>\u003c/p>\n\u003cp>By week four, I realized two things: Clinicians and researchers are actually better at lean startups than almost any other field. In medicine, you know what you don't know. No one believes that they've got everything figured out. I also learned that not only will it work, but the National Institutes of Health might be interested. The NIH came back and decided they wanted to run a version of the class inside their own organization. We were running 25 teams through the NIH six months later.\u003c/p>\n\u003cp>Today, some 40 universities are teaching a version of our program. And both the National Science Foundation and NIH have a training program for educators.\u003c/p>\n\u003cp>\u003cstrong>Did any of the students go on to start successful companies?\u003c/strong>\u003c/p>\n\u003cp>Yes, about half of the UCSF teams did go on to start companies. They also already had some small amount of funding at the start of class. The big challenge was to teach them that although they had money for idea X, perhaps idea X wasn't where they would end up. Some of the teams totally changed their core product by the end -- all based on the customer feedback they had gathered.\u003c/p>\n\u003cp>\u003cstrong>But who is the customer? Is it the organization that foots the bill or the patient? Or is it the doctor, who prescribes or recommends the product? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">\"It's clear that we're at an intersection of multiple crises in health care: electronic health record challenges, inflated costs, the price of getting a drug to market, the FDA bottleneck... But entrepreneurs need to see every crisis as an opportunity.\"\u003ccite>Steve Blank, father of the \"lean startup\" movement, serial entrepreneur and academic\u003c/cite>\u003c/aside>\n\u003cp>That's the challenge of turning the science into a company. In some cases, it's not clear whether the customer is the grandma that's going to put this product in her hip, the doctor, the hospital, or the insurance provider. The entrepreneur needs to consider all of these customers and think about regulation and reimbursement options too. They also need to check intellectual property or hire someone to do so.\u003c/p>\n\u003cp>\u003cstrong>Did many of your teams find that although they developed a useful product, it simply couldn't be commercialized?\u003c/strong>\u003c/p>\n\u003cp>Yes. And some learned that no one really wants the product. Or that there are barriers they didn't understand. In some cases, they learned that it would require 10 times more money to commercialize than expected. Almost 100 percent of the teams realized they needed to 'pivot' at least once, which means a substantive change to one or more business model assumptions.\u003c/p>\n\u003cp>\u003cstrong>Did you recommend to some of the clinicians and researchers in the class that they hire a technical or business person to lead the company? \u003c/strong>\u003c/p>\n\u003cp>One of the biggest mistakes that entrepreneurs make (and venture capitalists) is to only keep on the founding CEO for a year or two. I think the founder's vision and passion drives these things at an unparalleled speed and urgency.\u003c/p>\n\u003cp>\u003cstrong>What are some of the biggest lessons that you teach students in the class? \u003c/strong>\u003c/p>\n\u003cp>Some of the founding CEOs learn through the class how to communicate the complex science. What I tell them on day one is that the difference between the introvert and extrovert is whether they're looking at their shoes or my shoes. But either way, they figure out how to describe their projects in effective ways within three days. We teach them how to communicate to insurance companies, patients, regulators -- and not just to their peers.\u003c/p>\n\u003cp>\u003cstrong>You've learned a lot about health care through the class. What were your major takeaways? \u003c/strong>\u003c/p>\n\u003cp>Outside of life sciences, finding\u003ca href=\"https://en.wikipedia.org/wiki/Product/market_fit\"> product / market fit\u003c/a> is the number one thing you do. In the life sciences, that’s important but understanding if you have the freedom to operate [from an intellectual property standpoint] and who’s going to pay for it is equally important.\u003c/p>\n\u003cp>On a big picture level, it's clear that we're at an intersection of multiple crises in health care: electronic health record challenges, inflated costs, the price of getting a drug to market, the FDA bottleneck... But entrepreneurs need to see every crisis as an opportunity. Entrepreneurship is not a job; it's a calling.\u003c/p>\n\u003cp>\u003cstrong>You experienced the dotcom bubble and burst in the 1990s, having arrived to Silicon Valley in the late 70s. And now, the more recent wave of fervor for technology. What's changed?\u003c/strong>\u003c/p>\n\u003cp>In the 90s, no one made money until there was a liquidity event [like an acquisition or initial public offering]. Nowadays, most of the liquidity is in later-stage funds putting money in at exorbitant prices. These companies are worth something but not at that price -- and it inflates everything underneath it.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Venture capitalists are so desperate for deals they are allowing their entrepreneurs to do things that aren't necessarily the right thing. In my opinion, until social media, what venture capitalists invested in and what was good for the country was fairly aligned. What we did with social media is we took all the things people use to do face to face and now mediate that by a computer. That giant sucking sound is Facebook dragging money away from where money used to go: Green energy, education, health. Fortunately, that's starting to change.\u003c/p>\n\n","blocks":[],"excerpt":"Steve Blank is the father of the \"lean startup\" movement. Until recently, he didn't believe that his entrepreneurial methods could be applied to health care. ","status":"publish","parent":0,"modified":1437514214,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":31,"wordCount":1350},"headData":{"title":"Steve Blank: The \"Lean Startup\" Movement has Finally Reached Health Care | KQED","description":"Steve Blank is the father of the "lean startup" movement. Until recently, he didn't believe that his entrepreneurial methods could be applied to health care. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Steve Blank: The \"Lean Startup\" Movement has Finally Reached Health Care","datePublished":"2015-07-21T20:44:56.000Z","dateModified":"2015-07-21T21:30:14.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"15540 http://ww2.kqed.org/futureofyou/?p=15540","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/07/21/steve-blank-the-lean-startup-movement-has-finally-reached-health-care/","disqusTitle":"Steve Blank: The \"Lean Startup\" Movement has Finally Reached Health Care","path":"/futureofyou/15540/steve-blank-the-lean-startup-movement-has-finally-reached-health-care","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Silicon Valley entrepreneur Steve Blank is addicted to starting companies. So far, he's founded or worked at eight startups that run the gamut from video games to supercomputers.\u003c/p>\n\u003cp>Until recently, there was only one sector that he wouldn't touch: Health care. Blank said he did not see a way to apply his entrepreneurial methods to medicine, a sector that he viewed as slow to innovate.\u003c/p>\n\u003cp>Blank's ideas about startups and entrepreneurship are known around the world. Along with his former student from UC Berkeley Eric Ries, Blank is a leading proponent of the \"Lean Startup\" movement, which directs new companies to allocate their resources as sparingly as possible -- a challenging feat for many health care companies. \u003c/p>\n\u003cp>Blank has shared this approach with thousands of would-be entrepreneurs at top universities like Stanford, New York University, University of California, San Francisco and Imperial College London.\u003c/p>\n\u003cp>He teaches students to take a customer-centric approach by interviewing people about their needs, developing a basic prototype, testing it in the market, and then returning to the drawing board. Rinse and repeat. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In the wake of the Affordable Care Act and other health reforms, Blank has now changed his tune about health care. He now envisions a way for clinicians, doctors and researchers to bring new medical technologies to market using lean startup methods. This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>What was your turning point in thinking that your approach was relevant for health care?\u003c/strong>\u003c/p>\n\u003cp>I wrote in several books that the lean startup methods would work everywhere -- except for Life Sciences. As I saw it, there was this notion among scientists that there's no need to leave the building until the product works for everyone and everything. But I got a call from UCSF a few years ago. They said, 'Steve, we need you to put on a class. Whether it's digital health or therapeutics -- all of our students could benefit from a customer development process.' I decided to give it a shot.\u003c/p>\n\u003cp>\u003cb>How did you decide to structure the class?\u003c/b>\u003c/p>\n\u003cp>We had about 70 teams apply for about 20 spots. These student 'principal investigators,' who are typically researchers or surgeons, took the class and they picked a grad student and an industry mentor. We ended up splitting the class up into four categories: digital health, therapeutics, diagnostics and medical devices. We talked about everything from making improvements to existing products to innovations that had never existed before. The class itself was a prototype of sorts.\u003c/p>\n\u003cp>\u003cstrong>What did you learn along the way? \u003c/strong>\u003c/p>\n\u003cp>By week four, I realized two things: Clinicians and researchers are actually better at lean startups than almost any other field. In medicine, you know what you don't know. No one believes that they've got everything figured out. I also learned that not only will it work, but the National Institutes of Health might be interested. The NIH came back and decided they wanted to run a version of the class inside their own organization. We were running 25 teams through the NIH six months later.\u003c/p>\n\u003cp>Today, some 40 universities are teaching a version of our program. And both the National Science Foundation and NIH have a training program for educators.\u003c/p>\n\u003cp>\u003cstrong>Did any of the students go on to start successful companies?\u003c/strong>\u003c/p>\n\u003cp>Yes, about half of the UCSF teams did go on to start companies. They also already had some small amount of funding at the start of class. The big challenge was to teach them that although they had money for idea X, perhaps idea X wasn't where they would end up. Some of the teams totally changed their core product by the end -- all based on the customer feedback they had gathered.\u003c/p>\n\u003cp>\u003cstrong>But who is the customer? Is it the organization that foots the bill or the patient? Or is it the doctor, who prescribes or recommends the product? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">\"It's clear that we're at an intersection of multiple crises in health care: electronic health record challenges, inflated costs, the price of getting a drug to market, the FDA bottleneck... But entrepreneurs need to see every crisis as an opportunity.\"\u003ccite>Steve Blank, father of the \"lean startup\" movement, serial entrepreneur and academic\u003c/cite>\u003c/aside>\n\u003cp>That's the challenge of turning the science into a company. In some cases, it's not clear whether the customer is the grandma that's going to put this product in her hip, the doctor, the hospital, or the insurance provider. The entrepreneur needs to consider all of these customers and think about regulation and reimbursement options too. They also need to check intellectual property or hire someone to do so.\u003c/p>\n\u003cp>\u003cstrong>Did many of your teams find that although they developed a useful product, it simply couldn't be commercialized?\u003c/strong>\u003c/p>\n\u003cp>Yes. And some learned that no one really wants the product. Or that there are barriers they didn't understand. In some cases, they learned that it would require 10 times more money to commercialize than expected. Almost 100 percent of the teams realized they needed to 'pivot' at least once, which means a substantive change to one or more business model assumptions.\u003c/p>\n\u003cp>\u003cstrong>Did you recommend to some of the clinicians and researchers in the class that they hire a technical or business person to lead the company? \u003c/strong>\u003c/p>\n\u003cp>One of the biggest mistakes that entrepreneurs make (and venture capitalists) is to only keep on the founding CEO for a year or two. I think the founder's vision and passion drives these things at an unparalleled speed and urgency.\u003c/p>\n\u003cp>\u003cstrong>What are some of the biggest lessons that you teach students in the class? \u003c/strong>\u003c/p>\n\u003cp>Some of the founding CEOs learn through the class how to communicate the complex science. What I tell them on day one is that the difference between the introvert and extrovert is whether they're looking at their shoes or my shoes. But either way, they figure out how to describe their projects in effective ways within three days. We teach them how to communicate to insurance companies, patients, regulators -- and not just to their peers.\u003c/p>\n\u003cp>\u003cstrong>You've learned a lot about health care through the class. What were your major takeaways? \u003c/strong>\u003c/p>\n\u003cp>Outside of life sciences, finding\u003ca href=\"https://en.wikipedia.org/wiki/Product/market_fit\"> product / market fit\u003c/a> is the number one thing you do. In the life sciences, that’s important but understanding if you have the freedom to operate [from an intellectual property standpoint] and who’s going to pay for it is equally important.\u003c/p>\n\u003cp>On a big picture level, it's clear that we're at an intersection of multiple crises in health care: electronic health record challenges, inflated costs, the price of getting a drug to market, the FDA bottleneck... But entrepreneurs need to see every crisis as an opportunity. Entrepreneurship is not a job; it's a calling.\u003c/p>\n\u003cp>\u003cstrong>You experienced the dotcom bubble and burst in the 1990s, having arrived to Silicon Valley in the late 70s. And now, the more recent wave of fervor for technology. What's changed?\u003c/strong>\u003c/p>\n\u003cp>In the 90s, no one made money until there was a liquidity event [like an acquisition or initial public offering]. Nowadays, most of the liquidity is in later-stage funds putting money in at exorbitant prices. These companies are worth something but not at that price -- and it inflates everything underneath it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Venture capitalists are so desperate for deals they are allowing their entrepreneurs to do things that aren't necessarily the right thing. In my opinion, until social media, what venture capitalists invested in and what was good for the country was fairly aligned. What we did with social media is we took all the things people use to do face to face and now mediate that by a computer. That giant sucking sound is Facebook dragging money away from where money used to go: Green energy, education, health. Fortunately, that's starting to change.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/15540/steve-blank-the-lean-startup-movement-has-finally-reached-health-care","authors":["3252"],"categories":["futureofyou_1"],"tags":["futureofyou_171","futureofyou_80","futureofyou_531","futureofyou_530","futureofyou_529"],"featImg":"futureofyou_15828","label":"futureofyou"},"futureofyou_1722":{"type":"posts","id":"futureofyou_1722","meta":{"index":"posts_1591205157","site":"futureofyou","id":"1722","score":null,"sort":[1429131211000]},"guestAuthors":[],"slug":"meet-the-man-leading-californias-3m-precision-medicine-initiative","title":"Meet the Man Leading California's $3M 'Precision Medicine' Initiative","publishDate":1429131211,"format":"standard","headTitle":"Q&A | Future of You | KQED Future of You | KQED Science","labelTerm":{"term":54,"site":"futureofyou"},"content":"\u003cp>\"Precision medicine\" may seem like a vague and futuristic term. But for President Obama and other policymakers, it represents the future of cancer treatment and care.\u003c/p>\n\u003cp>For decades, doctors would prescribe treatments that work for some or most people -- a \"one sized fits all\" approach. But precision medicine proposes that care providers treat patients on an individual basis.\u003c/p>\n\u003cp>This week, the state of California stepped up its efforts to deliver more targeted health care by setting aside $3 million for precision medicine.\u003c/p>\n\u003cp>The program relies on support from patients, caregivers and researchers, including doctors and nurses. Many health experts are already on board, as precision medicine could dramatically improve how we treat serious diseases, like cancer and diabetes.\u003c/p>\n\u003cfigure id=\"attachment_1760\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"size-full wp-image-1760\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg\" alt=\"A timeline of precision medicine milestones\" width=\"370\" height=\"1190\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg 370w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-187x600.jpg 187w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-367x1180.jpg 367w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-320x1029.jpg 320w\" sizes=\"(max-width: 370px) 100vw, 370px\">\u003cfigcaption class=\"wp-caption-text\">A timeline of precision medicine milestones \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Atul Butte, a physician and computational health buff, has stepped up to lead California's $3 million initiative. \u003cem>KQED's Future of You\u003c/em> discussed with Butte the goals for the program,called the \"California Initiative To Advance Precision Medicine,\" a few of the challenges, and the real benefits for people. This interview has been edited and condensed for brevity.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Do patients understand this \"Precision Medicine\" idea? How will you communicate this initiative to the general public?\u003c/strong>\u003c/p>\n\u003cp>Honestly, I don't think most people do. We are still trying to define the phrase, and figure out how best to describe it to the public. President Obama mentioned it earlier this year in a speech, and positioned it as a way for the country to try to solve cancer. I use phrases like \"imagine a Google Maps for health\" or \"a new molecular approach to thinking about disease\" -- and I tell people that now we're in a position to really do something.\u003c/p>\n\u003cp>\u003cstrong>The analogy of \"Google Maps for health\" is catchy. Did you come up with it? And what does it mean?\u003c/strong>\u003c/p>\n\u003cp>I actually borrowed the term from a \u003ca href=\"http://www.ucsf.edu/sites/default/files/legacy_files/documents/new-taxonomy.pdf\">\u003cspan class=\"s2\">2011 report from the Institute of Medicine\u003c/span>\u003c/a>. Susan Desmond-Hellman and \u003ca href=\"http://yamamotolab.ucsf.edu/\">\u003cspan class=\"s2\">Keith Yamamoto\u003c/span>\u003c/a> and others from UCSF were part of a committee to decide what the future of medical research would be. The committee collected health data in all sorts of layers, including a layer for cost of care, for genomics, or for medications. But we are not connecting the dots between these layers. The analogy the committee used is with Google Maps, which pulls together in its visualization traffic data, restaurant ratings, building data and more. You need that kind of data integration for Life Sciences and medicine also.\u003c/p>\n\u003cp>\u003cb>KQED \u003c/b>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/20/ucsf-white-house-search-for-better-treatments-for-disease/\">\u003cspan class=\"s2\">\u003cb>recently visited your new digs at the UCSF Mission Bay\u003c/b>\u003c/span>\u003c/a>\u003cb> to meet with U.S. Department of Health and Human Services Secretary Sylvia Burwell and discuss the government's plans for Precision Medicine. What new details have emerged since then?\u003c/b>\u003c/p>\n\u003caside class=\"pullquote alignright\">“We're not looking at tiny bits of human DNA anymore, but the whole genome.\"\u003c/aside>\n\u003cp>Well, our plans date back to well before your visit in March. Governor Brown mentioned 'Precision Medicine' in the 2014 State of the Union Address. A pot of money -- $3 million -- was put into the state budget. We've been thinking since then about how to leverage that money.\u003c/p>\n\u003cp>We now know that we're planning to use it in two ways. We will start by collecting data that is necessary for us to provide Precision Medicine. We will determine questions like: Who has the assets? Is it groups of patients or genomics companies?\u003c/p>\n\u003cp>The bulk of the money, however, will go to two research pilots. These pilots will be run at multiple sites across the UC Health System.\u003c/p>\n\u003cp>\u003cstrong>How will you pick the two pilots? Will you setup a committee to evaluate all the proposals? And which diseases are you focusing on first?\u003c/strong>\u003c/p>\n\u003cp>We envision that all ten of the UC campuses will put in proposals. We may also get entries from Stanford and other California medical schools, as well as private biotech companies. We'll put together a committee in the next few weeks to decide on the two that will receive funding.\u003c/p>\n\u003cp>We're hoping that different campuses will work together and exchange relevant data. For instance, if two of the UC schools are exceptionally great at taking care of patients with breast cancer, they could pool data to develop specific drug therapies.\u003c/p>\n\u003cp>Cancer is an obvious target for Precision Medicine, and a lot of people are talking about that. We could also help kids with rare diseases.\u003c/p>\n\u003cp>\u003cstrong>How will you deal with some of the challenges of sharing data across different medical institutions? As recent articles \u003ca href=\"http://ww2.kqed.org/futureofyou/broken-medical-records\">(including a two-part series from KQED) \u003c/a>have demonstrated, much of this data isn't stored in a format that computers can ingest. And as you gather this sensitive data, how will you protect it?\u003c/strong>\u003c/p>\n\u003cp>A lot of this data is structured, which makes it easier for a computer to sort. But some of it, like imaging studies and text-based medical reports, are very difficult to process. There are some tools we can use, but we envision that many more tools will be developed in the next few years, whether it's from academia or private companies.\u003c/p>\n\u003cp>Another thing to highlight is that we want to make sure patients are involved in the process. We will make sure the data is anonymized and de-identified. We don't need to know who these patients are. We'll also be adding ethics and privacy advocates on the committee.\u003c/p>\n\u003cp>\u003cstrong>$3 million is a drop in the bucket when it comes to health care. Are you disappointed that there aren't more funds for the initiative?\u003c/strong>\u003c/p>\n\u003cp>Frankly, I am thrilled there is any money at all. Money for science from state budgets is hard to come by! But there may be more money in the future, potentially from private investors.\u003c/p>\n\u003cp>\u003cstrong>Speaking of patients, how will people benefit from this initiative in real and tangible ways? The initiative seems quite vague in its scope.\u003c/strong>\u003c/p>\n\u003cp>Let's be clear: This is a modest sum of money that will be spent on short-term trials. Some patients might enroll in these studies, particularly as existing studies expand to more UC centers. Those who participate at the early stages can learn about genetics. But the experience will not change for the average Californian.\u003c/p>\n\u003cp>\u003cstrong>How did you get involved in this field of \"computational health sciences\"? Will there be a hot market for jobs like this, which combine computer science and medicine skill-sets?\u003c/strong>\u003c/p>\n\u003cp>I started my career as a computer scientist, and used to work as a contractor for big companies like Apple. I later attended medical school and trained as a pediatrician. My advisors convinced me to go to \u003ca href=\"http://web.mit.edu/\">The Massachusetts Institute of Technology (MIT) to earn a PhD. \u003c/a>After graduating, I set up a lab to figure out how to better use medical data.\u003c/p>\n\u003cp>I just moved over to UCSF from Stanford at the beginning of April to build out the Institute for Computational Health Science. We'll be recruiting heavily.\u003c/p>\n\u003cp>The field of bioinformatics has been important for some time, but the significance is new. We're not looking at tiny bits of human DNA anymore, but the whole genome. The scope is much bigger. Bioinformatics is absolutely the career of the future.\u003c/p>\n\u003cp>\u003cstrong>What brought you to UCSF after over a decade at Stanford?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Bioinformatics is absolutely the career of the future.\"\u003c/aside>\n\u003cp>I loved Stanford, but UCSF offered two things I couldn't get there. It's a major medical center with large patient populations and resources that are required to build out a whole program in computational health. We're going to build a new building -- you need a large set of resources for that. Also, I have this physician link across all the UC health campuses. That's 13 million patients! We can really learn a lot from them, while we work to improve the consistency of care across the UC system.\u003c/p>\n\u003cp>\u003cstrong>Do you have any plans for new research that would reduce inefficiencies and help keep health care costs under control? And how about pricing, which can wildly differ between California hospitals?\u003c/strong>\u003c/p>\n\u003cp>Yes, there are a lot of inefficiencies in our health care system. I think data might shed light on where we can improve. I am hopeful we can reduce health care costs. How can we remove the piece that isn't needed?\u003c/p>\n\u003cp>Pricing depends on a complicated system of players, including payers. If I can even partially solve the cost problem, I'll see that as a success. Pricing is a different story.\u003c/p>\n\u003cp>\u003cstrong>How will the private sector get involved with this initiative? And are you looking at involving digital health tools from Silicon Valley's startups?\u003c/strong>\u003c/p>\n\u003cp>Yes, we expect that private industry will want to get involved. I have been getting tons of emails already from companies.\u003c/p>\n\u003cp>We envision that these pilots will draw on resources from the tech world, like Apple's ResearchKit, which offers an interesting way to recruit patients. We would also encourage research teams to use new tools and partner with companies like Apple or Samsung to get more outcomes data on their patients. What are patients like at home? How healthy are their habits? We need more real-world data.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>I am definitely optimistic about the role of technology in health care. Computers and digitization really has helped. We just need to make sure people aren't being left behind as we move into this digital age, and that everyone makes these transition away from paper-based systems in a safe and effective way.\u003c/p>\n\n","blocks":[],"excerpt":"The state of California just launched a $3 million \"Precision Medicine\" initiative. The project's leader, Dr. Atul Butte, opens up to KQED about some of the key challenges, including efforts to safeguard patient privacy. ","status":"publish","parent":0,"modified":1429133385,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":39,"wordCount":1637},"headData":{"title":"Meet the Man Leading California's $3M 'Precision Medicine' Initiative | KQED","description":"The state of California just launched a $3 million "Precision Medicine" initiative. The project's leader, Dr. Atul Butte, opens up to KQED about some of the key challenges, including efforts to safeguard patient privacy. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Meet the Man Leading California's $3M 'Precision Medicine' Initiative","datePublished":"2015-04-15T20:53:31.000Z","dateModified":"2015-04-15T21:29:45.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"1722 http://ww2.kqed.org/futureofyou/?p=1722","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/04/15/meet-the-man-leading-californias-3m-precision-medicine-initiative/","disqusTitle":"Meet the Man Leading California's $3M 'Precision Medicine' Initiative","path":"/futureofyou/1722/meet-the-man-leading-californias-3m-precision-medicine-initiative","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\"Precision medicine\" may seem like a vague and futuristic term. But for President Obama and other policymakers, it represents the future of cancer treatment and care.\u003c/p>\n\u003cp>For decades, doctors would prescribe treatments that work for some or most people -- a \"one sized fits all\" approach. But precision medicine proposes that care providers treat patients on an individual basis.\u003c/p>\n\u003cp>This week, the state of California stepped up its efforts to deliver more targeted health care by setting aside $3 million for precision medicine.\u003c/p>\n\u003cp>The program relies on support from patients, caregivers and researchers, including doctors and nurses. Many health experts are already on board, as precision medicine could dramatically improve how we treat serious diseases, like cancer and diabetes.\u003c/p>\n\u003cfigure id=\"attachment_1760\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003cimg class=\"size-full wp-image-1760\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg\" alt=\"A timeline of precision medicine milestones\" width=\"370\" height=\"1190\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2.jpg 370w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-187x600.jpg 187w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-367x1180.jpg 367w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Precision-Medicine-Timeline2-320x1029.jpg 320w\" sizes=\"(max-width: 370px) 100vw, 370px\">\u003cfigcaption class=\"wp-caption-text\">A timeline of precision medicine milestones \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Atul Butte, a physician and computational health buff, has stepped up to lead California's $3 million initiative. \u003cem>KQED's Future of You\u003c/em> discussed with Butte the goals for the program,called the \"California Initiative To Advance Precision Medicine,\" a few of the challenges, and the real benefits for people. This interview has been edited and condensed for brevity.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Do patients understand this \"Precision Medicine\" idea? How will you communicate this initiative to the general public?\u003c/strong>\u003c/p>\n\u003cp>Honestly, I don't think most people do. We are still trying to define the phrase, and figure out how best to describe it to the public. President Obama mentioned it earlier this year in a speech, and positioned it as a way for the country to try to solve cancer. I use phrases like \"imagine a Google Maps for health\" or \"a new molecular approach to thinking about disease\" -- and I tell people that now we're in a position to really do something.\u003c/p>\n\u003cp>\u003cstrong>The analogy of \"Google Maps for health\" is catchy. Did you come up with it? And what does it mean?\u003c/strong>\u003c/p>\n\u003cp>I actually borrowed the term from a \u003ca href=\"http://www.ucsf.edu/sites/default/files/legacy_files/documents/new-taxonomy.pdf\">\u003cspan class=\"s2\">2011 report from the Institute of Medicine\u003c/span>\u003c/a>. Susan Desmond-Hellman and \u003ca href=\"http://yamamotolab.ucsf.edu/\">\u003cspan class=\"s2\">Keith Yamamoto\u003c/span>\u003c/a> and others from UCSF were part of a committee to decide what the future of medical research would be. The committee collected health data in all sorts of layers, including a layer for cost of care, for genomics, or for medications. But we are not connecting the dots between these layers. The analogy the committee used is with Google Maps, which pulls together in its visualization traffic data, restaurant ratings, building data and more. You need that kind of data integration for Life Sciences and medicine also.\u003c/p>\n\u003cp>\u003cb>KQED \u003c/b>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/20/ucsf-white-house-search-for-better-treatments-for-disease/\">\u003cspan class=\"s2\">\u003cb>recently visited your new digs at the UCSF Mission Bay\u003c/b>\u003c/span>\u003c/a>\u003cb> to meet with U.S. Department of Health and Human Services Secretary Sylvia Burwell and discuss the government's plans for Precision Medicine. What new details have emerged since then?\u003c/b>\u003c/p>\n\u003caside class=\"pullquote alignright\">“We're not looking at tiny bits of human DNA anymore, but the whole genome.\"\u003c/aside>\n\u003cp>Well, our plans date back to well before your visit in March. Governor Brown mentioned 'Precision Medicine' in the 2014 State of the Union Address. A pot of money -- $3 million -- was put into the state budget. We've been thinking since then about how to leverage that money.\u003c/p>\n\u003cp>We now know that we're planning to use it in two ways. We will start by collecting data that is necessary for us to provide Precision Medicine. We will determine questions like: Who has the assets? Is it groups of patients or genomics companies?\u003c/p>\n\u003cp>The bulk of the money, however, will go to two research pilots. These pilots will be run at multiple sites across the UC Health System.\u003c/p>\n\u003cp>\u003cstrong>How will you pick the two pilots? Will you setup a committee to evaluate all the proposals? And which diseases are you focusing on first?\u003c/strong>\u003c/p>\n\u003cp>We envision that all ten of the UC campuses will put in proposals. We may also get entries from Stanford and other California medical schools, as well as private biotech companies. We'll put together a committee in the next few weeks to decide on the two that will receive funding.\u003c/p>\n\u003cp>We're hoping that different campuses will work together and exchange relevant data. For instance, if two of the UC schools are exceptionally great at taking care of patients with breast cancer, they could pool data to develop specific drug therapies.\u003c/p>\n\u003cp>Cancer is an obvious target for Precision Medicine, and a lot of people are talking about that. We could also help kids with rare diseases.\u003c/p>\n\u003cp>\u003cstrong>How will you deal with some of the challenges of sharing data across different medical institutions? As recent articles \u003ca href=\"http://ww2.kqed.org/futureofyou/broken-medical-records\">(including a two-part series from KQED) \u003c/a>have demonstrated, much of this data isn't stored in a format that computers can ingest. And as you gather this sensitive data, how will you protect it?\u003c/strong>\u003c/p>\n\u003cp>A lot of this data is structured, which makes it easier for a computer to sort. But some of it, like imaging studies and text-based medical reports, are very difficult to process. There are some tools we can use, but we envision that many more tools will be developed in the next few years, whether it's from academia or private companies.\u003c/p>\n\u003cp>Another thing to highlight is that we want to make sure patients are involved in the process. We will make sure the data is anonymized and de-identified. We don't need to know who these patients are. We'll also be adding ethics and privacy advocates on the committee.\u003c/p>\n\u003cp>\u003cstrong>$3 million is a drop in the bucket when it comes to health care. Are you disappointed that there aren't more funds for the initiative?\u003c/strong>\u003c/p>\n\u003cp>Frankly, I am thrilled there is any money at all. Money for science from state budgets is hard to come by! But there may be more money in the future, potentially from private investors.\u003c/p>\n\u003cp>\u003cstrong>Speaking of patients, how will people benefit from this initiative in real and tangible ways? The initiative seems quite vague in its scope.\u003c/strong>\u003c/p>\n\u003cp>Let's be clear: This is a modest sum of money that will be spent on short-term trials. Some patients might enroll in these studies, particularly as existing studies expand to more UC centers. Those who participate at the early stages can learn about genetics. But the experience will not change for the average Californian.\u003c/p>\n\u003cp>\u003cstrong>How did you get involved in this field of \"computational health sciences\"? Will there be a hot market for jobs like this, which combine computer science and medicine skill-sets?\u003c/strong>\u003c/p>\n\u003cp>I started my career as a computer scientist, and used to work as a contractor for big companies like Apple. I later attended medical school and trained as a pediatrician. My advisors convinced me to go to \u003ca href=\"http://web.mit.edu/\">The Massachusetts Institute of Technology (MIT) to earn a PhD. \u003c/a>After graduating, I set up a lab to figure out how to better use medical data.\u003c/p>\n\u003cp>I just moved over to UCSF from Stanford at the beginning of April to build out the Institute for Computational Health Science. We'll be recruiting heavily.\u003c/p>\n\u003cp>The field of bioinformatics has been important for some time, but the significance is new. We're not looking at tiny bits of human DNA anymore, but the whole genome. The scope is much bigger. Bioinformatics is absolutely the career of the future.\u003c/p>\n\u003cp>\u003cstrong>What brought you to UCSF after over a decade at Stanford?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Bioinformatics is absolutely the career of the future.\"\u003c/aside>\n\u003cp>I loved Stanford, but UCSF offered two things I couldn't get there. It's a major medical center with large patient populations and resources that are required to build out a whole program in computational health. We're going to build a new building -- you need a large set of resources for that. Also, I have this physician link across all the UC health campuses. That's 13 million patients! We can really learn a lot from them, while we work to improve the consistency of care across the UC system.\u003c/p>\n\u003cp>\u003cstrong>Do you have any plans for new research that would reduce inefficiencies and help keep health care costs under control? And how about pricing, which can wildly differ between California hospitals?\u003c/strong>\u003c/p>\n\u003cp>Yes, there are a lot of inefficiencies in our health care system. I think data might shed light on where we can improve. I am hopeful we can reduce health care costs. How can we remove the piece that isn't needed?\u003c/p>\n\u003cp>Pricing depends on a complicated system of players, including payers. If I can even partially solve the cost problem, I'll see that as a success. Pricing is a different story.\u003c/p>\n\u003cp>\u003cstrong>How will the private sector get involved with this initiative? And are you looking at involving digital health tools from Silicon Valley's startups?\u003c/strong>\u003c/p>\n\u003cp>Yes, we expect that private industry will want to get involved. I have been getting tons of emails already from companies.\u003c/p>\n\u003cp>We envision that these pilots will draw on resources from the tech world, like Apple's ResearchKit, which offers an interesting way to recruit patients. We would also encourage research teams to use new tools and partner with companies like Apple or Samsung to get more outcomes data on their patients. What are patients like at home? How healthy are their habits? We need more real-world data.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>I am definitely optimistic about the role of technology in health care. Computers and digitization really has helped. We just need to make sure people aren't being left behind as we move into this digital age, and that everyone makes these transition away from paper-based systems in a safe and effective way.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/1722/meet-the-man-leading-californias-3m-precision-medicine-initiative","authors":["3252"],"programs":["futureofyou_54"],"series":["futureofyou_135"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_15","futureofyou_194","futureofyou_29","futureofyou_200","futureofyou_103","futureofyou_141","futureofyou_190","futureofyou_34","futureofyou_138","futureofyou_197","futureofyou_196","futureofyou_171","futureofyou_80","futureofyou_112","futureofyou_170","futureofyou_198","futureofyou_113"],"featImg":"futureofyou_1750","label":"futureofyou_54"},"futureofyou_1394":{"type":"posts","id":"futureofyou_1394","meta":{"index":"posts_1591205157","site":"futureofyou","id":"1394","score":null,"sort":[1428681366000]},"guestAuthors":[],"slug":"23andme-ceo-we-are-now-the-poster-child-for-patient-empowerment","title":"23andMe CEO: We Are Now the 'Poster Child' for Patient Empowerment","publishDate":1428681366,"format":"standard","headTitle":"Q&A | KQED Future of You | KQED Science","labelTerm":{"term":135,"site":"futureofyou"},"content":"\u003cp>\u003cstrong>Update, 12:00 p.m. Oct 21: \u003c/strong>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/10/21/its-back-23andme-relaunches-its-consumer-gene-test/\">23andMe relaunched\u003c/a> its gene test with dozens of health reports, making it the first direct to consumer DNA test to gain approval from FDA.\u003c/p>\n\u003cp>\u003cstrong>Original story:\u003c/strong>\u003c/p>\n\u003cp>Many media pundits wrote off a genetic-testing start-up called \u003ca href=\"http://23andme.com\">23andMe\u003c/a> in November of 2013, when federal regulators ordered an immediate halt to sales of its flagship product.\u003c/p>\n\u003cp>In exchange for a swab of spit, Google-funded 23andMe provided people with direct access to over 200 health reports, detailing their risk of getting or carrying the gene mutation for a disease such as breast cancer or Parkinson's disease. But regulators\u003ca href=\"http://www.fda.gov/iceci/enforcementactions/warningletters/2013/ucm376296.htm\"> feared that people would misinterpret this health data\u003c/a>, which had not been clinically validated, or take action based on a \"false positive\" result.\u003c/p>\n\u003cp>Obstacles aside, the company has continued to \u003ca href=\"http://www.foxbusiness.com/markets/2015/03/12/dna-testing-firm-23andme-hires-biotechnology-executive-in-bid-to-develop-its/\">grow its team with some high-profile\u003c/a> hires, ink partnerships with big\u003ca href=\"https://www.genomeweb.com/genetic-research/23andme-pfizer-partner-genetic-research-target-lupus\"> pharmaceutical companies like Pfizer\u003c/a> and expand its customer base to more than 850,000 people. All this, while it continues to work with the U.S. Food and Drug Administration (FDA) to bring its DNA test back to market.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The secret to the company's success? Its unstoppable chief executive, Anne Wojcicki, who has stayed true to the company's core mission: To improve access to the human genome.\u003c/p>\n\u003cp>I spoke with Wojcicki shortly after a meeting with her ever-expanding staff, and a week before a rare vacation to a remote corner of the world with her sister, Susan Wojcicki, another Silicon Valley power player who works as the CEO of \u003ca href=\"http://youtube.com\">YouTube\u003c/a>. Our interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>23andMe has certainly had its critics over the years, as it's ambitious in scope. What prompted you to start the company in the first place?\u003c/strong>\u003c/p>\n\u003cp>As a young analyst on Wall Street, I invested in health care companies. I loved it, but I felt conflicted. I would go to parties filled with people in health care, and it was all about making money and having fun. I was also volunteering at hospitals in my spare time. I noticed this disconnect between the world that was making money on health care and those who are using it.\u003c/p>\n\u003cp>I still cringe at the U.S. health care system that is focused on optimizing revenues, versus improving access to care. I wanted to democratize access and I also knew that very little money was spent on prevention. 23andMe is focused on showing people their health risks. If I can do that, I think I'm doing a great service.\u003c/p>\n\u003cp>\u003cstrong>What are some of the most eye-opening discoveries you've made by using your own service?\u003c/strong>\u003c/p>\n\u003cp>I remember the first time my family took the test, because we found out that Sergey [Brin, cofounder of Google and Wojcicki's husband] was a carrier for the LRRK2 gene, making him a carrier for Parkinson's Disease. That was monumental. We also found out that I have a higher risk for breast cancer and I'm a carrier of an inherited disease called \u003ca href=\"http://ghr.nlm.nih.gov/condition/bloom-syndrome\">Bloom's Syndrome\u003c/a>. I am now more proactive about my diet.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I still cringe at the U.S. health care system that is focused on optimizing revenues, versus improving access to care.\"\u003cbr>\n\u003ccite>Anne Wojcicki, 23andMe CEO\u003c/cite>\u003c/aside>\n\u003cp>Another cool thing is the first time you see that your children are actually our children. Obviously I know they're mine as I saw them being born. But when you can see it in a digital form, it's pretty awesome. It's one of those moments where you feel like you're part of this legacy.\u003c/p>\n\u003cp>[Editors' Note: Wojcicki is still legally married to Google cofounder Sergey Brin, but the pair are separated. Google invested \u003cspan class=\"st\">$3.9 million in 23andMe in 2007.\u003c/span>]\u003c/p>\n\u003cp>\u003cstrong>Were you surprised by the FDA's warning letter? Or did you expect to overcome some major hurdles with this company?\u003c/strong>\u003c/p>\n\u003cp>When I worked on Wall Street, we knew that stocks would go up and go down. Likewise, we have always anticipated that there would be ups and downs with an ambitious company like this, which is focused on helping people understand, access and benefit from the human genome. The FDA letter was obviously a big bump in the road for us, but our board and our investors understood from the beginning that it wasn't going to be easy.\u003c/p>\n\u003cp>\u003cstrong>You recently experienced a small victory, with the FDA approving your test for a rare genetic disease called Bloom Syndrome. How did you feel when you heard the news?\u003c/strong>\u003c/p>\n\u003cp>It was one of the first times in the company that we had a standing ovation. We felt a ton of pride. On a personal level, this has been a big lesson. There is a level of steps and patience that is required. I'm trying not to inhale the health revolution all at once.\u003c/p>\n\u003cp>I also felt fortunate to have Kathy Hibbs [\u003ca href=\"https://www.linkedin.com/pub/kathy-hibbs/40/679/a0a\">23andMe's chief legal and regulatory officer\u003c/a>] on board. We understood even back in 2010 that we would be regulated as a medical device. But there was a lot of miscommunication on our behalf. With Kathy, we have someone who has paved the way towards getting the product to market.\u003c/p>\n\u003cp>\u003cstrong>What's next in the pipeline for approval after Bloom Syndrome?\u003c/strong>\u003c/p>\n\u003cp>I'm playing the role of the obedient CEO and deferring to Kathy [Hibbs] on this. With the Bloom Syndrome approval, the FDA \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm435003.htm\">down-classified \u003cspan class=\"st\">autosomal recessive disorder\u003c/span>s.\u003c/a> We're pretty excited about that. \u003ca href=\"http://www.nigms.nih.gov/Research/SpecificAreas/PGRN/Background/Pages/pgrn_faq.aspx\">We are also looking at pharmacogenetics [how individuals respond to drugs]\u003c/a>; the BRCA gene test for breast cancer and disease risks, including Alzheimer's Disease.\u003c/p>\n\u003cp>\u003cstrong>A recent Washington Post article \u003ca href=\"http://www.washingtonpost.com/national/health-science/23andme-co-founder-anne-wojcickis-washington-charm-offensive/2014/06/27/b465b086-f240-11e3-9ebc-2ee6f81ed217_story.html\">described you as being on the \"charm offensive\" in D.C.\u003c/a>, as you have been seen liaising with folks from the White House and other federal agencies. Why the shift in focus?\u003c/strong>\u003c/p>\n\u003cp>One of the benefits of the warning letter from the FDA is that it brought me to D.C. often for conversations with policymakers. We weren't in D.C. enough before.\u003c/p>\n\u003cp>23andMe is now seen in D.C. as a poster child for this \"consumer empowerment\" movement, as we've spoken out publicly on this topic. I've said many times that consumers with no background in medicine can understand complicated ideas. We're seeing this idea circulate on the Hill that it's the right time for the consumer to transition from subject to participant.\u003c/p>\n\u003cp>\u003cstrong>We've heard your name in association with the President's \"Precision Medicine\" initiative. How involved have you been?\u003c/strong>\u003c/p>\n\u003cp>We are not that involved, but I have been super impressed with the initiative so far. They called out the fact that there should be far more consumer engagement in health care. For example, why hasn't there been a single federally funded study where consumers get their genetic information? All this money is going into research, but participants aren't getting their data back.\u003c/p>\n\u003cp>I saw Eric Green [director of the \u003ca href=\"http://www.genome.gov/\">National Human Genome Research Institute\u003c/a>] last night. There is definitely a vision in the government to get a larger number of people engaged and leverage a lot of data. They have to put together a plan for the initiative soon. I feel lucky I'm not part of it. It's going to be a lot of work over the next three months.\u003c/p>\n\u003cp>\u003cstrong>You've been partnering up with big pharmaceutical vendors and other stakeholders. How can we be sure that you won't detract from the core mission, and end up like the money-guzzling entities you encountered on Wall Street? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"There's men, there's women and then there's assholes. I recommend trying to work with the men and the women.\"\u003cbr>\n\u003ccite>Anne Wojcicki, 23andMe CEO\u003c/cite>\u003c/aside>\n\u003cp>Pharma isn't all bad. It's a necessary component of the health care system. They are the ones who make the therapies. But I do want us to do things differently in making sure the consumer is part of the solution, and we also want to continue to do work on prevention. I'm also keeping an eye on different health care models in other parts of the world, which I feel morally better about.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"http://www.forbes.com/sites/matthewherper/2015/03/12/23andme-enters-the-drug-business-just-as-apple-changes-it/\">23andMe is getting into drug invention,\u003c/a> which seems very ambitious given the high costs of bringing a new pharmaceutical to market. How will you find the resources?\u003c/strong>\u003c/p>\n\u003cp>We're going to do it differently. I find it outright crazy that so few firms are researching who this drug will work for. We want to do the right thing even if it means cutting down our market size.\u003c/p>\n\u003cp>There are so many inefficiencies in drug development and we'll take a different approach in clinical trial recruitment. We have almost a million people and growing, and we'll recruit directly from our database. As for the money, it will be solvable if we get to that point. We'll raise the funds if we have good target ideas.\u003c/p>\n\u003cp>\u003cstrong>What's next for the future? How about sequencing the whole genome, given the \u003ca href=\"http://www.nature.com/news/technology-the-1-000-genome-1.14901\">recent claims that it can be done for $1000\u003c/a>?\u003c/strong>\u003c/p>\n\u003cp>We are definitely thinking about sequencing. It's high on our list of priorities and topics. We've always said we'll move into it when it finally gets to an even more consumer-friendly price point.\u003c/p>\n\u003cp>\u003cstrong>Finally, KQED's Future of You \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/23/what-digital-health-lacks-female-ceos/\">published some findings\u003c/a> on the lack of gender diversity in health care. Any advice for would-be female founders?\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>There's men, there's women and then there's assholes. I recommend trying to work with the men and the women! On a more serious note though, there should be more women in the industry. Gender diversity leads to more innovation for the entire sector.\u003c/p>\n\n","blocks":[],"excerpt":"23andMe's secret weapon? Its mission-driven, straight-talking CEO Anne Wojcicki. She opens up with KQED about DNA, diversity and more.","status":"publish","parent":0,"modified":1477283137,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":38,"wordCount":1639},"headData":{"title":"23andMe CEO: We Are Now the 'Poster Child' for Patient Empowerment | KQED","description":"23andMe's secret weapon? Its mission-driven, straight-talking CEO Anne Wojcicki. She opens up with KQED about DNA, diversity and more.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"23andMe CEO: We Are Now the 'Poster Child' for Patient Empowerment","datePublished":"2015-04-10T15:56:06.000Z","dateModified":"2016-10-24T04:25:37.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"1394 http://ww2.kqed.org/futureofyou/?p=1394","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/04/10/23andme-ceo-we-are-now-the-poster-child-for-patient-empowerment/","disqusTitle":"23andMe CEO: We Are Now the 'Poster Child' for Patient Empowerment","path":"/futureofyou/1394/23andme-ceo-we-are-now-the-poster-child-for-patient-empowerment","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update, 12:00 p.m. Oct 21: \u003c/strong>\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/10/21/its-back-23andme-relaunches-its-consumer-gene-test/\">23andMe relaunched\u003c/a> its gene test with dozens of health reports, making it the first direct to consumer DNA test to gain approval from FDA.\u003c/p>\n\u003cp>\u003cstrong>Original story:\u003c/strong>\u003c/p>\n\u003cp>Many media pundits wrote off a genetic-testing start-up called \u003ca href=\"http://23andme.com\">23andMe\u003c/a> in November of 2013, when federal regulators ordered an immediate halt to sales of its flagship product.\u003c/p>\n\u003cp>In exchange for a swab of spit, Google-funded 23andMe provided people with direct access to over 200 health reports, detailing their risk of getting or carrying the gene mutation for a disease such as breast cancer or Parkinson's disease. But regulators\u003ca href=\"http://www.fda.gov/iceci/enforcementactions/warningletters/2013/ucm376296.htm\"> feared that people would misinterpret this health data\u003c/a>, which had not been clinically validated, or take action based on a \"false positive\" result.\u003c/p>\n\u003cp>Obstacles aside, the company has continued to \u003ca href=\"http://www.foxbusiness.com/markets/2015/03/12/dna-testing-firm-23andme-hires-biotechnology-executive-in-bid-to-develop-its/\">grow its team with some high-profile\u003c/a> hires, ink partnerships with big\u003ca href=\"https://www.genomeweb.com/genetic-research/23andme-pfizer-partner-genetic-research-target-lupus\"> pharmaceutical companies like Pfizer\u003c/a> and expand its customer base to more than 850,000 people. All this, while it continues to work with the U.S. Food and Drug Administration (FDA) to bring its DNA test back to market.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The secret to the company's success? Its unstoppable chief executive, Anne Wojcicki, who has stayed true to the company's core mission: To improve access to the human genome.\u003c/p>\n\u003cp>I spoke with Wojcicki shortly after a meeting with her ever-expanding staff, and a week before a rare vacation to a remote corner of the world with her sister, Susan Wojcicki, another Silicon Valley power player who works as the CEO of \u003ca href=\"http://youtube.com\">YouTube\u003c/a>. Our interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>23andMe has certainly had its critics over the years, as it's ambitious in scope. What prompted you to start the company in the first place?\u003c/strong>\u003c/p>\n\u003cp>As a young analyst on Wall Street, I invested in health care companies. I loved it, but I felt conflicted. I would go to parties filled with people in health care, and it was all about making money and having fun. I was also volunteering at hospitals in my spare time. I noticed this disconnect between the world that was making money on health care and those who are using it.\u003c/p>\n\u003cp>I still cringe at the U.S. health care system that is focused on optimizing revenues, versus improving access to care. I wanted to democratize access and I also knew that very little money was spent on prevention. 23andMe is focused on showing people their health risks. If I can do that, I think I'm doing a great service.\u003c/p>\n\u003cp>\u003cstrong>What are some of the most eye-opening discoveries you've made by using your own service?\u003c/strong>\u003c/p>\n\u003cp>I remember the first time my family took the test, because we found out that Sergey [Brin, cofounder of Google and Wojcicki's husband] was a carrier for the LRRK2 gene, making him a carrier for Parkinson's Disease. That was monumental. We also found out that I have a higher risk for breast cancer and I'm a carrier of an inherited disease called \u003ca href=\"http://ghr.nlm.nih.gov/condition/bloom-syndrome\">Bloom's Syndrome\u003c/a>. I am now more proactive about my diet.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"I still cringe at the U.S. health care system that is focused on optimizing revenues, versus improving access to care.\"\u003cbr>\n\u003ccite>Anne Wojcicki, 23andMe CEO\u003c/cite>\u003c/aside>\n\u003cp>Another cool thing is the first time you see that your children are actually our children. Obviously I know they're mine as I saw them being born. But when you can see it in a digital form, it's pretty awesome. It's one of those moments where you feel like you're part of this legacy.\u003c/p>\n\u003cp>[Editors' Note: Wojcicki is still legally married to Google cofounder Sergey Brin, but the pair are separated. Google invested \u003cspan class=\"st\">$3.9 million in 23andMe in 2007.\u003c/span>]\u003c/p>\n\u003cp>\u003cstrong>Were you surprised by the FDA's warning letter? Or did you expect to overcome some major hurdles with this company?\u003c/strong>\u003c/p>\n\u003cp>When I worked on Wall Street, we knew that stocks would go up and go down. Likewise, we have always anticipated that there would be ups and downs with an ambitious company like this, which is focused on helping people understand, access and benefit from the human genome. The FDA letter was obviously a big bump in the road for us, but our board and our investors understood from the beginning that it wasn't going to be easy.\u003c/p>\n\u003cp>\u003cstrong>You recently experienced a small victory, with the FDA approving your test for a rare genetic disease called Bloom Syndrome. How did you feel when you heard the news?\u003c/strong>\u003c/p>\n\u003cp>It was one of the first times in the company that we had a standing ovation. We felt a ton of pride. On a personal level, this has been a big lesson. There is a level of steps and patience that is required. I'm trying not to inhale the health revolution all at once.\u003c/p>\n\u003cp>I also felt fortunate to have Kathy Hibbs [\u003ca href=\"https://www.linkedin.com/pub/kathy-hibbs/40/679/a0a\">23andMe's chief legal and regulatory officer\u003c/a>] on board. We understood even back in 2010 that we would be regulated as a medical device. But there was a lot of miscommunication on our behalf. With Kathy, we have someone who has paved the way towards getting the product to market.\u003c/p>\n\u003cp>\u003cstrong>What's next in the pipeline for approval after Bloom Syndrome?\u003c/strong>\u003c/p>\n\u003cp>I'm playing the role of the obedient CEO and deferring to Kathy [Hibbs] on this. With the Bloom Syndrome approval, the FDA \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm435003.htm\">down-classified \u003cspan class=\"st\">autosomal recessive disorder\u003c/span>s.\u003c/a> We're pretty excited about that. \u003ca href=\"http://www.nigms.nih.gov/Research/SpecificAreas/PGRN/Background/Pages/pgrn_faq.aspx\">We are also looking at pharmacogenetics [how individuals respond to drugs]\u003c/a>; the BRCA gene test for breast cancer and disease risks, including Alzheimer's Disease.\u003c/p>\n\u003cp>\u003cstrong>A recent Washington Post article \u003ca href=\"http://www.washingtonpost.com/national/health-science/23andme-co-founder-anne-wojcickis-washington-charm-offensive/2014/06/27/b465b086-f240-11e3-9ebc-2ee6f81ed217_story.html\">described you as being on the \"charm offensive\" in D.C.\u003c/a>, as you have been seen liaising with folks from the White House and other federal agencies. Why the shift in focus?\u003c/strong>\u003c/p>\n\u003cp>One of the benefits of the warning letter from the FDA is that it brought me to D.C. often for conversations with policymakers. We weren't in D.C. enough before.\u003c/p>\n\u003cp>23andMe is now seen in D.C. as a poster child for this \"consumer empowerment\" movement, as we've spoken out publicly on this topic. I've said many times that consumers with no background in medicine can understand complicated ideas. We're seeing this idea circulate on the Hill that it's the right time for the consumer to transition from subject to participant.\u003c/p>\n\u003cp>\u003cstrong>We've heard your name in association with the President's \"Precision Medicine\" initiative. How involved have you been?\u003c/strong>\u003c/p>\n\u003cp>We are not that involved, but I have been super impressed with the initiative so far. They called out the fact that there should be far more consumer engagement in health care. For example, why hasn't there been a single federally funded study where consumers get their genetic information? All this money is going into research, but participants aren't getting their data back.\u003c/p>\n\u003cp>I saw Eric Green [director of the \u003ca href=\"http://www.genome.gov/\">National Human Genome Research Institute\u003c/a>] last night. There is definitely a vision in the government to get a larger number of people engaged and leverage a lot of data. They have to put together a plan for the initiative soon. I feel lucky I'm not part of it. It's going to be a lot of work over the next three months.\u003c/p>\n\u003cp>\u003cstrong>You've been partnering up with big pharmaceutical vendors and other stakeholders. How can we be sure that you won't detract from the core mission, and end up like the money-guzzling entities you encountered on Wall Street? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"There's men, there's women and then there's assholes. I recommend trying to work with the men and the women.\"\u003cbr>\n\u003ccite>Anne Wojcicki, 23andMe CEO\u003c/cite>\u003c/aside>\n\u003cp>Pharma isn't all bad. It's a necessary component of the health care system. They are the ones who make the therapies. But I do want us to do things differently in making sure the consumer is part of the solution, and we also want to continue to do work on prevention. I'm also keeping an eye on different health care models in other parts of the world, which I feel morally better about.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"http://www.forbes.com/sites/matthewherper/2015/03/12/23andme-enters-the-drug-business-just-as-apple-changes-it/\">23andMe is getting into drug invention,\u003c/a> which seems very ambitious given the high costs of bringing a new pharmaceutical to market. How will you find the resources?\u003c/strong>\u003c/p>\n\u003cp>We're going to do it differently. I find it outright crazy that so few firms are researching who this drug will work for. We want to do the right thing even if it means cutting down our market size.\u003c/p>\n\u003cp>There are so many inefficiencies in drug development and we'll take a different approach in clinical trial recruitment. We have almost a million people and growing, and we'll recruit directly from our database. As for the money, it will be solvable if we get to that point. We'll raise the funds if we have good target ideas.\u003c/p>\n\u003cp>\u003cstrong>What's next for the future? How about sequencing the whole genome, given the \u003ca href=\"http://www.nature.com/news/technology-the-1-000-genome-1.14901\">recent claims that it can be done for $1000\u003c/a>?\u003c/strong>\u003c/p>\n\u003cp>We are definitely thinking about sequencing. It's high on our list of priorities and topics. We've always said we'll move into it when it finally gets to an even more consumer-friendly price point.\u003c/p>\n\u003cp>\u003cstrong>Finally, KQED's Future of You \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/03/23/what-digital-health-lacks-female-ceos/\">published some findings\u003c/a> on the lack of gender diversity in health care. Any advice for would-be female founders?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There's men, there's women and then there's assholes. I recommend trying to work with the men and the women! On a more serious note though, there should be more women in the industry. Gender diversity leads to more innovation for the entire sector.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/1394/23andme-ceo-we-are-now-the-poster-child-for-patient-empowerment","authors":["3252"],"series":["futureofyou_135"],"categories":["futureofyou_1060","futureofyou_1064"],"tags":["futureofyou_15","futureofyou_36","futureofyou_17","futureofyou_138","futureofyou_120","futureofyou_61","futureofyou_171","futureofyou_80","futureofyou_170"],"featImg":"futureofyou_1396","label":"futureofyou_135"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. 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