by Chris Kenji Beer.

A “Tsunami” of Ai is Coming to Health Care

In his book “The Structure of Scientific Revolutions” (1962), Thomas Samuel Kuhn referred to science as “a series of peaceful interludes punctuated by intellectually violent revolutions  . . . in each of which one conceptual world view is replaced by another.” There are a number of innovative companies diving into “intellectually violent revolutions”, including the likes of gut microbiome companies such as uBiome and Viome, and genetic sequencing companies such as Illumina, BGI Genomics, 10x Genomics.

Naveen Jain recently founded Viome, a leading personalized microbiome gut sequencing technology company that uses deep machine learning and data science to offer optimal health care solutions for its customers. One of Jain’s “Moonshot” goals is to “truly make illness optional.” To do so, we must “think like the future has already arrived.”

Like “icing on the cake” layered on top of our “return to our roots” health care grounded in the food we eat, are innovative Ai, machine learning, and new medical technology. These lead the way to transforming an industry that has been consumed by pharmaceutical drugs for decades. The industry is now equally steeped in controversy with limited results, and lots of damaging side effects such as the opioid epidemic. But taking on the powerful health care industry, the pharmaceutical industry, and the insurance industry, is nothing short of bold.

For entrepreneurs however, this all just means more problem solving, and more opportunity. Imagine the intellectual revolutions taking place today in health care. You have access to health care for billions of people by simply using innovations in entrepreneurship. Serial entrepreneur Naveen Jain believes there is a big wave of Ai coming to the health sector. “There is a tsunami that’s coming,” he told CNBC in a TV interview from the Slush technology conference in Helsinki, Finland (December 01, 2017). Jain partly attributes this tsunami to the huge demand for sensors that are driving down the prices, making Ai (artificial intelligence) technology more available to the masses. “The sensors are becoming so cheap. For the first time in our lifetime, we can look deep inside our body to know exactly what is going on,” he told CNBC.

Biotechnology and health care startups are using Ai to discover a deeper and more detailed understanding of the mind and body. “Ai is going to play the biggest role because there is so much more data than humans can ever process,” according to Viome’s Jain.

The Current Health Care System is Obsolete.

Disruptive innovators believe the current health care system is broken or dysfunctional at best in so many ways. Today’s health care and technology has advanced beyond the system’s ability to control it. As the system becomes large, it becomes an organism set up to survive; it believes that only the stake holders of the system matter – “the hospitals, pharmaceutical companies, and insurance companies, says Jain. The customers are just a nuisance the system has to deal with in order to get paid.” “That is why the system is completely broken at this point. Pharmaceutical companies have become a parasite of humanity. Their sole purpose is to keep you sick.” When you have a chronic disease and you have a CEO of a pharmaceutical company who says that ‘the best drug we develop is the one that people must take for the rest of their life.’ The best drug is not the one that cures the disease, the best drugs are the ones that suppress the symptom so that you must take it for the rest of your life. That kind of system is essentially using people as guinea pigs to keep making money from us.” Today, “90% of health care costs are going toward chronic diseases”, so the burgeoning class of biotech and health care entrepreneurs is filling the gap to solve the problems of diseases.

One way to break this cycle of dependency is the use of modern technology at the ground level — in our local communities. “Instead of building hospitals,” says Naveen Jain using one example, “what if you can buy a $25 tablet device for a girl in a village who studies and learns to become a doctor online? She studies the nature of ailments prevailing in her home country and is able to address their health care needs with an app that evaluates personalized and individualized care for each patient in the village for a tiny sum of 25 cents per person.”

Mind- Body Connection

The history of modern medicine in the U.S. and Europe had a defining moment in the 17^thCentury led by Rene Descartes. The “Cartesian duality” of mind and body stated that the mind and body are independently functioning parts. Today, we can no longer assume this traditional western belief that the brain and body are independently functioning. Not only do we know the mind and body are intimately interconnected, but they are immersively interdependent, constantly communicating, and working collaboratively together. Scientific communities all over the world are delving deeper into researching the intricacies and connections between the mind and body.

The brain – microbial body connections seem endless, as the engine of microbial research redefines the health care industry.

It is striking how the holistic health traditions of Asia seem to parallel modern innovative Ai driven health care pursuits. This includes data driven, microbial gut research, food- based solutions, and preventive holistic health care to support a healthy mind and body.

Viome- Personalized, Customer-Centric Health Care

So what does all this cutting edge research on the brain- to- gut connection mean? The research is driving change in the entire health care industry. It not only suggests a deep interconnection between the bacteria in our body to our brain, but it also opens health care to almost unlimited possibilities for answers and opportunities for solutions to today’s health care problems. “Our health is very personal, and very individually unique, so why is not health care applied at a personal, customer- centric, individual level?”

This all points toward Naveen Jain’s assertion that the large institutional systems currently in place, from healthcare to education, are becoming obsolete. Advancements in health care are rapidly moving the way of the entrepreneur and innovative startups. Jain’s Bluedot first spin off, Viome, now possesses the technology and deep learning capability to streamline our visions about health into a neural and biological network down to the fully personal, customizable molecular level. “Viome.com is able to identify/quantify all living organisms (bacteria, viruses, yeast, fungus & mold) and more importantly look at their functional pathways to analyze what they are actually doing.”

“Viome is able to factor in chemical activities in the body from foods we eat, the effects of bacteria or viruses in our bodies, and the medicines we consume”. Viome is able to break down their impacts through artificial intelligence data combined with scientific and medical expertise to offer highly specific “actionable insights” to maximize the person’s health. Viome offers this data by analyzing the identify species and strains of bacteria, but also viruses, yeast, mold, and fungi in our gut. Viome’s Los Alamos Laboratory- driven technology analyzes their RNA, or ribonucleic acid. This technology was originally designed for the national security at Los Alamos National Labs and licensed by Viome has enabled a person’s complete microbiome test. The tests give visibility into which bacteria, viruses, yeast, fungus or mold are present in too great or little quantities.

While Viome has been selling beta tests to thousands of customers at a monthly clip of $59, or $595 annually. However, the ever conscious entrepreneur in Jain knows that pivoting may be an option in the future, and said the company may consider fees as low as $10, even free, then generate sales off of the recommendations it makes. Viome raised an initial $6 million early 2017, and then announced an additional round in August of 2017 of $15 million led by Khosla Ventures with participation by Bold Capital Partners, totalling $21 million in 2017.

Institutional Innovations:

I and others assert that the current institutions that dominate the health care landscape have become part of the problem. This is not to suggest that all institutions are left completely out of the innovations role. Highly customizable and personalized health care solutions are at the cutting edge of disruptive innovation. You do not need to be an established entity to drive these disruptions, but you can be. The innovative applications of a person’s DNA sequence such as the tool for synthesizing DNA invented by biologist Leroy Hood’s Institute for Systems Biology, offer customizable health care at a genetic level, called genotyping. Seattle area’s Swedish Health Services has been recognized nationally for providing highly customized and personalized health care using Dr. Hood’s DNA sequencing.

Creator of the CRISPR Cas9 technology, CRISPR Caribou Biosciences CEO, Dr. Jennifer Doudna invented the ability to edit our genetic code. Doudna showed how CRISPR, or “clustered regularly-interspaced short palindromic repeats”, “bacteria’s natural defense system could be turned into a ‘gene editing’ tool to cut DNA strands”, according to the Genetic Literacy Project. In addition to founding CRISPR, she teaches chemistry and molecular biology at University of California Berkeley. Both Hood and Doudna are said by peers to be up for the Nobel Prize.

Dr. Hood helped his associates at Swedish Health Services play a leadership role in innovation, according to its then CEO Anthony Armada. “On the clinical side, for example, Swedish is the first to apply truly ‘personalized medicine’ using genotyping. Genotyping is a fingerprint of who you are genetically,” he adds. “For example, there can be five potential cures for a particular cancer. Genotyping can test and determine which of the five offers the best results, the least risk, and the best course of action for that particular patient” (source: NW Asian Weekly, Beer; August 04, 2016). Thanks to help from Dr. Hood, the founding father of genomics, the hospital is leading the country in the medical and scientific applications of genomics.

Other Health Care Disruptors:

Other disruptors in health care include Mark Zuckerberg’s $600 million funded biotechnology center in Silicon Valley. BioHub’s premier project is to create a vast directory of human cells, which it calls a “cell atlas.” (source: Antonio Regalado, MIT Technology Review, October 31, 2016). Stanford researcher and BioHub Co-President Steven Quake and BioHub are also part a consortium of researchers around the globe who are collaborating to map the millions of cells in the human body. Scientists at BioHub and elsewhere are inspecting tens of millions of human cells for their molecular signatures, among other things, to track the body’s specific immune system responses to different treatments such as radiation.

Like Viome’s collection of gut samples, uBiome now has a database of nearly 100,000 gut samples collected from its early adopter consumers the company refers to as “citizen scientists”, according to a 2016 TechCrunch article (Sara Buhr, November 01, 2016). “The GI tract is teeming with bacteria and research suggests the wrong kind may play a role in diabetes, multiple sclerosis, cancer, liver disease, obesity, irritable bowel syndrome and a number of other maladies.” uBiome features a new SmartGut screening test kit that you can buy online for an estimated $89 which aims to identify “dozens of microbial genera and species” using a 16S rRNA gene sequencing method. These are only a snapshot of disruptive innovators in the health care space.

Viome’s Genetic Code Priniciples:

Viome expands on the genetic code principles. Viome is a personalized “life optimization” health care solution using complex biological data and the most advanced, cutting edge technology originating from Los Alamos Laboratory. Viome takes highly customized information about how the body functions at a molecular and microscopic level. “Viome is able to identify relationships with species and strains of bacteria, viruses, bacteriophages, fungi, and parasites within the human body and apply highly specific customized and personalized biochemical analysis and solutions to maximize each individual’s health”. There are three pillars to the Viome solution, according to their website (see http://viome.com), using microbiome gene expression, gut metabolites, metabolome, and genetics:

1) SCIENCE: Comprehensive metabolome and microbiome analysis resulting in high resolution complex biological data at a molecular level using a cost effective proprietary process.

2) DATA: Viome processes the customer’s samples in their state- of- the- art facilities to help generate a picture of your body at a molecular level. The company combines that with their doctor-trained artificial intelligence (Ai) engine to generate actionable diet, exercise, and nutrient recommendations.

3) INSIGHT: Viome offers an artificially intelligent, contextually relevant recommendation engine.

BlueDot unlocks valuable inventions by re-imagining research from top labs in order to solve humanity’s most pressing global challenges. Viome was formed by BlueDot by applying entrepreneurial skills to create cutting-edge technology derived from the research of organizations such as Los Alamos Laboratory and other national labs and universities”. Viome is the first of perhaps many spin offs of Blue Dot.

Why Viome is a leader in healthcare innovation is partly because it recognizes that the lion’s share of a person’s genetics resides in their gut, a whopping upwards of 90%! No other company has achieved the genetic makeup of the gut that Viome has and as deep and extensive data analysis. Ubiome falls short in this area.

A few takeaways here are that marketplace disruptions as in the case of Viome, can come from industry outsiders like Naveen Jain, technologies such as the military from Los Alamos labs. Direct-to-consumer applications which remove middlemen such as those of Viome and Ubiome offer more efficient and cost effective solution for health care consumers. It is not always about “reinventing the wheel” as it is “‘repurposing’ or ‘re- imagining’ the wheel”, as Jain likes to say. Technology and ideas can be repurposed for another business sector and be a disruptive innovation. Also, pre-existing technologies and creations at the academic and laboratory level are common sources of marketplace innovations in health care, as in the case of Silicon Valley’s CRISPR Caribou Biosciences and BioHub. This again reinforces the assertion that disruptive innovations come from anywhere.

Circling back to the original theme of this chapter, referring to Thomas Kuhn again, the study of the enteric nervous system, gut microbiome research and applying it to health care solutions, has effectively created arguably the greatest disruptive innovation of this generation.