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How Clinical Genetics is Paving The Way in Precision Health

Episode 416

Recommended Book:

The Hard Thing About Hard Things by Ben Horowitz

Best Way to Contact Dekel:

dekel@fdna.com

Mentioned Link:

FDNA website

How Clinical Genetics is Paving The Way in Precision Health with Dekel Gelbman, CEO at FDNA transcript powered by Sonix—the best audio to text transcription service

How Clinical Genetics is Paving The Way in Precision Health with Dekel Gelbman, CEO at FDNA was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2019.

Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes, and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez.

Saul Marquez:
Welcome back to the podcast. Today I have the privilege of hosting Dekel Gelbman. He’s the CEO at FDNA. FDNA is a company that initially started with facial analysis and hence the F in the DNA. He’s the founding CEO of the company. There he leads the corporate and business strategy that turned the company from early stage startup, developing next generation geno typing, and GP technologies into a global leader in A.I., Genomics, and precision medicine. FDNA is a developer of Face to gene, the leading phenotype platform in the clinical genomics space powered by the largest and fastest growing phenotyping database in the world. Dekel has extensive experience in business development, legal counseling and regulatory compliance. Mr. Gelbman has worked closely with dozens of startups companies including some of the most innovative technological companies from a wide variety of fields. Following them through from seed stage to exit. Mr. Gelbman previously worked at the Corporate Finance Group at Skadden, Arps, Slate, Meagher and Flom and Affiliates. And so it’s a true pleasure to have him here on the podcast to really touch on a lot of the things that are forefront on the mind of healthcare leaders today, A.I. Genomics, Precision Medicine. So, Dekel, thanks so much for being with us.

Dekel Gelbman:
Absolutely. Thank you very much, Saul, for having me.

Saul Marquez:
So why don’t we start with the genesis of it all Dekel? What got you into healthcare?

Dekel Gelbman:
Well, you know, Saul it’s funny. I don’t recall ever making a conscious decision to get into healthcare. You know, about 10 years ago, I was in the peak of my career as a corporate attorney. I represented many of the entrepreneurs basically that are in position that I am right now. And I guess I always wanted to be on the side that created value rather than helping others create value. The medical space itself has so many opportunities for creating value. What’s almost guaranteed in this space is that the value that you’re creating is going to impact people’s lives in the most significant way possible. So ten years ago, when I met Moti Shniberg and Lior Wolf, the co-founders of FDNA, and when I heard what they’re trying to do, I saw unbelievable value. And I immediately left my comfortable job and teamed up with them to pursue our mission, which is saving lives of kids with rare diseases.

Saul Marquez:
Well, I think it’s fabulous that you took that risk Dekel. And as you look in your rearview mirror, there was no looking forward. There was no guarantee of success. And looking back now, you’re like, “wow, this thing worked out.” So, you know, you’ve been through a lot of different things now, a lot of different companies as well. I love to hear from you what you believe needs to be forefront on the mind of leaders agendas and healthcare and how are you and FDNA approaching it?

Dekel Gelbman:
So today I’m a bit biased towards this subject, but I think that every medical leader should be considering how AI fits into their agenda, whatever it is. Specifically, there are a number of topics that we pay a lot of attention to, and I think that everyone should. first and foremost, how to separate the hope from the hype. So in other words, what can AI actually do and what it can’t do? And I think that’s even more important to understand and realize. You need to understand what to embrace and what to reject. So that distinction is extremely important for any medical leaders agenda. Beyond that, and this falls kind of into subcategories of A.I. is how to control the quality of data. Everyone knows the same garbage in, garbage out. So how do we avoid biases in equities that are inherent in an A.I., artificial intelligence? Then and this is a little bit more specific to the medical space. How do you integrate A.I. successfully into the workflow in the medical space, specifically in healthcare professionals workflow that that really is extremely important. I can’t really emphasize how important that is. And another thing that I think should be important for medical leaders when considering A.I. is starting to talk about how to share data. Because if we don’t share data, we end up working in silos. And that kind of ties back into the biases, the inequities and other really bad stuff that is associated with A.I., unfortunately. And finally, you know, being an ex lawyer, I’m always preoccupied with the legality and ethics specifically in this evolving space where the legislators are lagging. So we have to think as leaders, we have to take corporate responsibility and think how we form this new field, if you will.

Saul Marquez:
Dekel, you’ve you’ve laid out an excellent foundation or framework, rather, for any leader looking to to think about A.I. and the different things that they should be concerned with. You’ve obviously been spending a lot of time on this. And have had success with it. Give us an example maybe of something that happened, at FDNA, a result that was created and how you guys improved outcomes in business processes by doing it differently.

Dekel Gelbman:
So I have to say the most recent notable milestone for us, I think was the Nature Medicine manuscript that was published in January early this year. It didn’t change the adoption of our solutions by healthcare professionals, which is how we measure our success currently. But it clearly demonstrates and validates the clinical utility and the value that we’ve created for thousands of clinicians around the world and even more importantly, for hundreds of thousands of patients that are diagnosed or were diagnosed with the help of our technology. So I think that’s the main value that we can already demonstrate. So usage, one of them, and then validation scientific validation the other. And that kind of leads us as a segway to to our next challenge, which is slightly related to improving business processes, I would say, but also within healthcare, which is how we fully integrate our technology into not only the clinical evaluation workflow by healthcare professionals, but also into did genetic testing workflow. A lot is being said right now about genomics, the role that genomics is going to play in healthcare, how genetic testing is going to evolve. And we need to be able to show to demonstrate that we can integrate our technology into that workflow, into the processing of genetic information by augmenting the genetic analysis that’s done in the lab.

Saul Marquez:
Fascinating. And so is you and your team work to bring these technologies to the forefront of medicine. The frontline or clinicians are are making an impact. You mentioned a list of a couple of things that, hey, you know, things could go wrong. The legality of things, policy governing this work, clean data, maybe you could share with us an example of a roadblock you ran into and what you learned from that roadblock that’s made you in the company more successful today.

Dekel Gelbman:
So in other words, failures. Where should I start? Listen, every successful product I think that we launch or that anyone for that matter, launches is should start as a series of failures. I don’t think that we’re enlightened. I don’t think that we came up with with a solution or all by ourselves. We patiently amen with a lot of grit, with a lot of dedication to our mission. And we’ve observed and we started to develop and then we failed over and over and over again until we succeeded. So there are I think 99% of what we do is failure. Until we have that success, it’s just not visible and you can take it anywhere. You know, the workflow that we started with was entirely wrong until we went and observed how clinicians actually work. The data security and architecture on the cloud was a disaster. Before we went to a site, a political site, deployed it and encountered their rigorous I.T. specialists and privacy specialists that reviewed it and said, you know, that will not work for us. So our path is full of failures. And I want to say one thing. First of all, I don’t think that we had any huge mistakes here. But I want to say one thing that I think captures the essence of startups in the healthcare industry. And I think this is contrary to the Facebook or the Silicon Valley approach of move fast and break things. In healthcare, you have to move slow and fix things because that’s how it works. You don’t get a second chance or not a lot of second chances. So we have to be very conservative. You have to move very slow. You have to observe the system. You have to play with the system and not try to disrupt it.

Saul Marquez:
I think that is very insightful Dekel and that playing with the system without disrupting it. You know, so many folks make the mistake of wanting to disrupt it. It’s a very you know, everybody talks about, you know, healthcare is already fixed. You can’t fix it. It’s already fixed. Okay. So work within it. And that’s the reality. The improvements that are being made within it, examples such as the FDNA is doing is huge of what can happen when you play with the system and then start doing your part to make it better. So, you know, just a message for everybody listening right now from Dekel. Something to take note of. And the beauty of podcasts, you can always rewind it. Relisten to it. Maybe you got distracted. This is one that you’re going to want listen to. So Dekel thanks for that insight and so really appreciate that failure story. Tell us about the other side of that coin. What’s been one of your proudest leadership experiences at FDNA?

Dekel Gelbman:
For me personally, it doesn’t matter how many articles are published about FDNA, how many scientific publications, how many talks I participate. How many patents we get, the amount of investments. These are all great moments in the life of any startup, any entrepreneur. But hands down, the most proudest moment for me is when I hear from families, when I hear when I get any sort of message of gratitude from a family of a patient with a rare disease, that’s just pure pride and joy for me.

Saul Marquez:
Love that Dekel. That’s the sign of your mission’s core and your truth to that. So I give you a lot of credit for it. And so when you do your work and and you make the step of impact, it’s awesome to get those outreach. The outreach you’re getting. Tell us about an exciting project that you’re most looking forward to today.

Dekel Gelbman:
So, yeah, sure. I’m. We’re working on some really exciting stuff, specifically on several partnerships that will soon be publicly announced. One of them already publicly announced where we’re focused right now. So one of them, as I alluded to earlier, is working with labs. We’re working with several genetic testing labs about integrating our technology as part of that, as an integral part of the process of genetic testing. So basically the ability adding the ability to look at a patient and observe the clinical signs will amplify the ability of interpreting the genomic test results significantly. Today, if you look at genome sequencing, typically, I would say on average it yields a diagnostic rate of about 25%. It’s only 25% of the cases actually end up with a diagnosis. We’ve recently done a study where we showed that for syndromic patients, that is patients that have those observable clinical signs that we can detect. We’re able to triple that number. So, yeah, it actually makes sense because if you dive deeper into the genetic testing details, you’ll know that any genome sequencing reveals thousands, literally thousands of abnormal results. And so the task shifts back to the person that needs to sift through all these results and decide what is pertinent, what is pathogenic, what causes the disease. To do that, the person, the human being looking at these results has to go back to the patient and understand the clinical signs. So we call that phenotyping. Hence, we’re doing next generation phenotyping. We’re using AI to discover those phenotypes and to be able to communicate with the bioinformatics element of the genetic tests.

Saul Marquez:
That is fascinating. I had no idea it was that low 25%.

Dekel Gelbman:
Mainly I would say there are two reasons for that. One, is it just a burdensome task to go through all these different variants of genetic variations and try to associate them with a disease. So that takes up a lot of time. As you know, time is really scarce acid and the medical space. And the other thing is knowledge. So we still don’t know enough about the genetic causes of many diseases, even if they’re what we call a monogenic. Even if they’re caused by a single gene, it’s really hard to to get to the root of that with genome sequencing. So by combining these these different types of technologies or different approaches, we aim to significantly increase the value of genome sequencing. Another project that we’re working on and this actually was publicly announced is a partnership with a contracted research organization called CO Events, one of the largest COO’s out there. We’re working on improving the recruitment of clinical trials for clinical trials and the rare disease space. So there is really limited access to patients with rare diseases and that causes delays and even sometimes puts at risk the actual trials, which means that all the drug development efforts that are depending on these trials are hindered. Sometimes drugs don’t come to market. We want to fix that. So that’s really exciting. And then finally, we’re working with pharma on specifically where there are already drugs on the market that could benefit patients with rare diseases. One of the problem is we can’t find these patients in time to have the treatments efficient or effective. So we’re trying to work with pharma on identifying patients at risk earlier in life and being able to deliver these lifesaving drugs to them. So a lot of but everything is really exciting and we’re working really hard to get that done.

Saul Marquez:
Well, you know what Dekel, sounds like you definitely have a lot that gets you up early in the morning and just makes sure that you stay on top of it. So appreciate you sharing all those exciting updates and. So you were here at the point of the interview where we do a lightning round. I’ve got a couple of questions for you. Lightning Round style, followed by your favorite book recommendation for the listener. You ready?

Dekel Gelbman:
Yeah, sure.

Saul Marquez:
All right. What’s the best way to improve healthcare outcomes?

Dekel Gelbman:
I’ll give you my recipe. It has several stages, right?

Saul Marquez:
Yeah.

Dekel Gelbman:
Study the clinical workflow through observation. That is by far the most important thing. You have to be extremely humble and go and observe. Identify the sources of data with the highest integrity that is super important. Validate. Publish. Publish. Publish. Whatever you can. That is the most valuable marketing asset that you have. You have to gain trust with a wide user base and that’s it. Put all these things in the oven and be patient. It’s going to take some time.

Saul Marquez:
I love it Dekel. This is great. And folks, again, you know, Dekel is dropping a lot of value here. So hit that rewind button. The recipe for outcomes improvements. And so what would you say is the biggest mistake or pitfall to avoid?

Dekel Gelbman:
In health care?

Saul Marquez:
Yes.

Dekel Gelbman:
I would say over promising and under delivering. I think I said this before in this interview, you rarely get a second chance. Integrity is probably the most important asset that you bring to the table. And so be humble. Don’t over promise, don’t over market. I don’t want to go into names, but there are a lot of pretty large companies out there that in the AI space that have over promised and as a result, they were just completely rejected by this audience.

Saul Marquez:
It’s a great call out. And how do you stay relevant as an organization despite constant change?

Dekel Gelbman:
I think this is something that is not unique for the medical space. I think that every company should remain true to their mission statement as kind of a target destination. Ours is to help and diagnostic odyssey over disease patients. And I think everything else is secondary. So you can look at every other thing as either a shortcut or a detour. And the way to that target destination. But if you stay true to that destination, you’ll get there.

Saul Marquez:
Brilliant. And what’s one area of focus that drives everything in your organization?

Dekel Gelbman:
I think, you know, the patients well-being is what we care about. And so we have a lot of areas of focus that serve that purpose. One is, you know, being at the cutting edge of A.I. The other is how to provide the best workflow experience to patients, how to demonstrate and validate results. How to share be transparent with our users and respect them. So all that is all those are areas where we try to do our best.

Saul Marquez:
I love that. And Dekel, I have two extra ones that I’ve been asking more recently to help you make a more personal connection with the listener. So first one is, what is your number one health habit?

Dekel Gelbman:
That is changing pretty frequently. But I try to eat healthy, recently started a ketogenic diet and it’s I think it’s really promising, although questionable. So you have to really stay focused on how to eat healthy and exercising moderately.

Saul Marquez:
I love it. And what is your number one success habit?

Dekel Gelbman:
Don’t get stressed.

Saul Marquez:
Easier said than done.

Dekel Gelbman:
Yeah, but I think you know, I think it also relates to the previous one. So just don’t get stressed from anything. It clouds your judgment.

Saul Marquez:
Love that. Some great value there Dekel. And really appreciate you gone through that list with us. What book would you recommend to the listeners?

Dekel Gelbman:
If we’re talking about business books and if your listeners happen to be CEO’s of startups? The Hard Thing About Hard Things by Ben Horowitz. That book changed my professional life. And so I think it can save you hours and hours of psychoanalytics. Just go and read the book.

Saul Marquez:
Great.

Dekel Gelbman:
If not, then I would say Sapiens by Yuval Noah Harari. It’s an interesting book. Easy reading. It has so much history cramped into it and it presents some very interesting theories about how mankind evolved. So that’s something that I think could give you some perspective on life, about society.

Saul Marquez:
Love that. Some great recommendations there Dekel and folks for the show notes as well as a full transcript, then links to the books that Dekel recommended as well as links to FDNA. Go to outcomesrocket.health and in the search bar type in FDNA and you’ll find that there. So Dekel, just want to give you a big thanks and ask. Let the listeners know a parting thought and the best place where they could learn more about what you’re doing.

Dekel Gelbman:
So I’ll give you my personal, I believe, which is if you want to change something in your life and your world, doesn’t really matter, you have to have a true mission that you believe in. Otherwise, you know, the distractions, the temptations, the frustrations, they’re all going to throw you off course. So that’s my personal philosophy, if you will. And about FDNA, you can log in to www.fdna.com or you can reach me at dekel@fdna.com.

Saul Marquez:
Beautiful. Dekel, this has been a true pleasure and a privilege. Keep up the outstanding work. And thanks again for carving out some time with us.

Dekel Gelbman:
Thank you so much, Saul.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.

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