Increasing Access to Genomic Health
Episode 415

Lisa Alderson, Co-Founder and CEO at Genome Medical, Inc.

Increasing Access to Genomic Health

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Increasing Access to Genomic Health

Episode 415

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Genome Medical

Increasing Access to Genomic Health with Lisa Alderson, Co-Founder and CEO at Genome Medical, Inc. transcript powered by Sonix—the best audio to text transcription service

Increasing Access to Genomic Health with Lisa Alderson, Co-Founder and CEO at Genome Medical, Inc. 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.

Saul Marquez:
Welcome back to the Outcomes Rocket. Today, I have the privilege of hosting Lisa Anderson. She's the co-founder and CEO of Genome Medical. She has more than 20 years of experience building early stage companies with a focus on technology, consumer and life science businesses. She's a seasoned founder, board member, investor and adviser with the work that she's doing at Genome Medical. They're leading telegenomics. They're dedicated to bringing genomics to every day care through its nation wide network of genetic specialists and efficient genomic care delivery platform. Genome Medical is providing health expertise throughout the genomic journey. Prior to her experience there, she served as the Chief Commercial Officer and Chief Strategy Officer of Invitae, a rapidly growing genetic information company. She was also the former CEO and President of CrossLoop Inc. Marketplace for Technology Services. Among other many other companies that have all been acquired. So she's got a history of founding and leading businesses with an MBA from Harvard Business School. A true privilege to have Lisa here on the podcast today. Thanks for joining, Liza.

Lisa Alderson:
Hey, thank you. Saul, I appreciate it. That was very complete and comprehensive.

Saul Marquez:
And much more so, folks. That was just a little snapshot. Lisa's done a lot of awesome things. But today, we're gonna be focused on genomics and the gap that exists today and why everybody listening has an opportunity to take advantage of that. So, Lisa, before we dive into that, I'd love to hear more about you and why you decided to be in health care.

Lisa Alderson:
Yeah. Thank you Saul. You know, I've always been passionate about building businesses, and in particular, I'm driven to industries where technology is a major driver of change. Honestly I can't think of a field where technology innovation is more needed than in healthcare. So I was introduced to the field of genomics around 2000, and that's when we were sequencing the first human genome. And I really became fascinated by the complexity of the biology of disease and this promise of personalized medicine or precision medicine based in part on our genomic information. And over the years, frankly, as I've had many friends and family members been affected by disease and in many cases inheritable conditions, it's just become so clear to me how critically important it is that we translate these advancements in the field of genomics into everyday clinical care for patients all around the country. And that's really what motivates me and inspires me every day to shepherd in this new era of genomic medicine in a really medically responsible way, but a very efficient manner that enables patients everywhere to have increased access. And that's important because it can be life savings. It can help patients to better understand a diagnosis and help providers better select treatment options.

Saul Marquez:
Lisa, there's no doubt that there's there's huge promise in this. What what do you see as the biggest obstacle to to access?

Lisa Alderson:
So one of the biggest challenges is that genomics as a field has expanded so rapidly that the vast majority of clinicians are not yet knowledgeable in terms of how to appropriately use genomic based medicine. And so there's three primary barriers. One is identifying which patients would most benefit. The second is actually selecting the right test and that's very complex because there's over 60000 different genomic tests now on the market. And then the third is how to interpret the resulting information. This is not as black and white and simple as a high cholesterol test. And so the results that come back can sometimes be ambiguous, sometimes have very clear medical management guidelines. And as those medical management guidelines evolve, you know, it can take clinical expertise typically from a geneticist, which is an M.D. or a genetic counselor, which is a mid-level medical professional, to understand the action ability of the information and to guide to appropriate treatment decisions based upon the individual's test results, as well as their personal and family health history.

Saul Marquez:
Yeah, that's interesting. There's there's that need for navigation since it is so new and even the experts need a little navigation help along with the people using it, for the leaders listening today, what would you say is that hot topic that needs to be front and center for them around this genomics?

Lisa Alderson:
Well, you know, I think it's first understanding that genomics is a critical component to any precision medicine strategy. And as the medicine, the science and the technology have evolved, it really takes clinical support tools to, you know, to to bring genomics into everyday care. One thing that's exciting about genomics is actually touches almost all areas of medicine. So eventually, you know, all primary care and specialty areas like cancer and cardiovascular disease and neurological conditions and kind of rare genetic conditions. They they're there will be a stronger anchor in the future of how we deliver health care that relies on our molecular makeup, basically our genetic and genomic information. It's just that historically we've not had the tools to be able to affordably access that information. And yet it's our life code. So as you can imagine, your DNA makes you you. It's one of the strongest contributors to our health and therefore being able to more affordably and medically, responsibly access that information to guide both prevention strategies, as well as get to a more accurate diagnosis faster and ultimately utilize that information to guide to the more efficacious treatment strategy makes a ton of sense. It's really just a question of how do we get from where we are, which is currently a bit chaotic into a more ordered future where genomic based medicine is a cornerstone in everyone's clinical care.

Saul Marquez:
And what does that future look like?

Lisa Alderson:
Well, so there's many ways in which genomic based medicine is currently being adopted and where clinical utility as well demonstrated, where medical management guidelines are in place and where reimbursement coverage is even in place. And the two biggest areas are around cancer and around reproductive health. So around cancer, as an example, if we could identify individuals and I'll just use one example, let's say colon cancer, if we could identify individuals at an elevated risk for colon cancer before they become symptomatic, we could then perform a colonoscopy, remove a polyp. And ultimately, you know, more efficacious early treat that patient and think about that first for the benefit of the patient. But second, for the cost savings to the health care system, because treating no advanced stage colon cancer is, of course, much more costly than performing a cancer screening a colonoscopy and removing a polyp. And so not only does that result in a better outcome for the patient, but at a macro level, you know, it also can lead to more efficacious care and more cost effective care. And so if across a large patient population, if we could stratify that patient population and identify individuals at high risk for cancer or high risk for cardiovascular disease, know even patients needing medication management, then we could more appropriately provision care to meet the needs of that individual. And thus we'd move from kind of one standard of care for all where we know we're over treating a portion of the population and we're under treating those with highest need into a stratified patient care approach that enables us to better meet the needs of the high risk cohort versus that low to moderate risk cohort.

Saul Marquez:
Love it. Yeah, and it makes a lot of sense to go that route. And just as stewards of our health care resources, you know, I feel like it's it's a moral obligation to get there. So I think it's cool that you guys are working on it.

Lisa Alderson:
Well, thank you. As I say in particular, where one of the biggest challenges is, is again, where we have the guidelines in place and we have reimbursement coverage in place. We're still missing the majority of these patients and because it controls so dramatically, affect their own personal care. You know, I personally. That's what motivates me every day is how do we. How do we get to those patients faster? And, you know, how to how do we help identify their need and then provision appropriate care.

Saul Marquez:
Love that. So, Lisa, tell us a little bit about an example of how you guys have created results and, you know, improved outcomes, increased profitability by doing things differently. Yeah.

Lisa Alderson:
So we are developing. A very targeted approach to delivering genomic based medicine. And it delivers about four times the results at half the spend of the more traditional approach. So just to dive in on that a little bit. First, most genetics and genomics. Genomics today exists at leading academic centers. And yet the vast majority of patients are seen in the community setting. Only about 17 percent of community health systems have access to even one genetic counselor. And so for that community health system, we can provide comprehensive care and support across six different specialty areas cancer, cardiovascular, pediatrics, pharma, genomics, which is the study of your gene to drug interactions, reproductive health and then general proactive health. And that we do for less than the cost of hiring a single genetic counselor. And so for a health system that is working with Genome Medical, suddenly it enables much more efficient access to genetic services and allows that community health system to retain the patient within their health system. In the large academic centers and kind of leading genetic departments, we actually augment their clinical care. So in many cases, the referral rate to genetics has grown exponentially. I mean, it's growing about 25 percent year over year. And yet, of course, that workforce of geneticists and genetic counselors has not grown. And so where there are these centers of excellence, typically we're seeing, you know, growing demand growing faster than that. You know, the the geneticist and genetic counselors can keep up. And that's resulting in longer wait times to be seen. So we can augment an existing department based in genetic services and help create more efficient and faster access to genetics. And so really, we mostly work with hospitals and health systems, although we do see patients directly. And for the patient that self refers, you know, we're able to serve as patients in all 50 states. In fact, we have seen patients in all 50 states and we are basically delivering virtual based care. So everything by telehealth, either a video consultation or a phone based consultation. And so really it comes down to improved access and improved kind of cost of care because we're investing in building really two things. One, the world's largest network of clinical genomics expertise. And then second, in a genomic care platform that enables more efficient delivery of genomic based services.

Saul Marquez:
I think it's brilliant. And you know, what about the payers? You know, how do they fit into this?

Lisa Alderson:
So we are working on becoming a network provider with national and regional payers. We are currently in a network provider with Cigna. That's our first major national payer contract or in process of contracted and credentialing with many others. We do accept insurance. So if we are an out of network provider, we have patient financial assistance plans and we take a low cost. It's 50 dollar visit fee amendment assignment of benefits. So even if we are an out of network provider today, we still are able to support and see patients. And in many cases, when we're working with hospitals and health systems, it's actually that the health system that is supporting the cost of our service delivery to handle billing and reimbursement.

Saul Marquez:
Hey, that's pretty cool, Lisa. So so you mean the model that you have here? You're you're both, you know, sort of playing from the industry side, but also because you have providers working at the company, you're also a provider.

Lisa Alderson:
That's right. I mean, we are a medical practice. We are set up as the first and only nationwide medical practice in genomics. Yeah.

Saul Marquez:
That is interesting. I love that. It's it's it's a very unique business model.

Lisa Alderson:
It is. You know, I mean, I think our observation and why we wanted to kind of set ourselves up in that manner is that there's there's so much investment that's gone on into the industry to advance the science and the technology and, you know, build molecular diagnostic based lab tests. And so much of that infrastructure is now in place. And actually what's missing is the service delivery infrastructure. I think of it as almost. A last mile access problem where, you know, we we have we have the medicine, we have the science, we have the technology, we just can't get it into the hands of every provider and every patient. And in particular, where it's a covered benefit, the individuals not receiving access, you know, can can just be a real challenge. And so so we're we're focused on that. Nuts and bolts, you know, challenging aspects of delivering patient care to patients in all 50 states and not only supporting the patient directly, but actually supporting the non genetics provider, the clinician, and better understanding how to utilize genomic based medicine. And by doing so, we believe we can elevate the entire industry because it's been shown that non genetics professionals actually order the wrong test about a third of the time. And when these are costly tests, of course, we need to bridge that knowledge gap and bring the right tools and clinical support across the industry. And so that's very much what medical focus is on. And when we work with large health systems, it's all about how do we bring forward the right tools and then serve as the expert as a support mechanism to help ensure appropriate clinical care for the patient.

Saul Marquez:
Well Lisa you and your team are definitely providing a lot of the resources for, you know, the caregivers and the patients and folks. You're listening to this today, thinking to yourself, wow, this is this is pretty neat. How do I get engaged? How do I work with Lisa and her team so that I could take my health system and our care to the next level? We'll definitely be sharing how to get in touch with Lisa and the team at Genome Medical. So don't go anywhere. Right now I want to. I want to talk about it. Just a setback. You know, I feel like you've been at the helm of so many different companies, Lisa, and now Genome Medical. You've had a lot of success. Tell us about a setback you had, whether it be a genome at the starting or another company. But what did you learn from that lesson?

Lisa Alderson:
You know, I I'm a longtime entrepreneur. This is the eighth company I've either founded or been a part of the startup team. And honestly, there is just so many at every juncture, almost every day where you're you're feeling like, you know, you're you're trying to overcome some major challenge. And, you know, one of my co-founders often says success feels like, you know, eating gravel right.. just hard. And, you know, I would say as I look back on my two decade career, probably the most significant challenge in time I faced was actually early in my career. And that's kind of going back to 1999 when we had this dot com boom and then followed by the dot com bust. And I was a senior executive actually at a technology startup when the market conditions just changed so dramatically that our board of directors, you know, a very proactive way came to us and suggested that we do a mass reduction in force and effectively laid off about 40 per cent of the workforce, you know, in a 24 hour period. And that was just very significantly challenging for me. I mean, one, it was earlier in my career but to it just really sat with me because I felt like, you know, it was not due to anything other than market condition.

Saul Marquez:
Right.

Lisa Alderson:
But, you know, honestly, what came out of that, I think, was a smaller and stronger team. And we were then able to pivot quickly and move in a different direction and ultimately merged with another privately held company. And it frankly remains a large and growing company today. So it ended up being the right decision. But working through that just took a lot out of me. I mean, it was probably the point, my career, where I most felt depleted after all of that and just recharge.

Saul Marquez:
Yeah. You know, and it's it's interesting. I mean, you know, those those those lows being able to manage those lows and then, you know, learn from them is is critical. So interesting that you guys rebuild to get out of that and and be able to shift in a way that, you know, helped grow the company. What would you say? The other side of the coin to that is what's one of your proudest leadership experiences to date? And if it's OK, I'd love to hone in on Genome Medical thus far.

Lisa Alderson:
Yeah, of course. You know. I mean, I think I was really proud the moment we had succeeded in seeing patients in all 50 states. There's actually quite a challenge to setting up a medical practice and not just a medical practice, but a medical practice that is a license to practice medicine in 50 states. And it you know, it took us a good 18, 24 months to be able to build to that outcome. But for me, that helped solve the first barrier that I'm trying to solve, which is how do we open up access to genetic and genomic expertise for patients everywhere, not dependent upon the zip code under which you live, not dependent upon your ability to navigate to a leading academic center but for all patients everywhere and you know, that is not the end of our journey. But that was a really important milestone to enable, you know, telehealth genomics to patients all across the United States. And so I was really proud of the team that was able to work to make that happen and frankly proud of our team on a daily basis that are seeing patients all across the country and really changing what, you know, what life looks like for those patients. And that's everything from, you know, children with rare genetic condition seeking a diagnosis to cancer patients seeking the optimal treatment. You know to new families starting off and wanting to ensure the health of a new child. And so one of the things that's so compelling about genomics is that it's really about a lifelong journey from, you know, conception all the way through, you know, toddler years and achieving major developmental milestones up to, you know, in your 20s and 30s and 40s and looking at risk for cancer and cardiovascular disease. And then, you know, ultimately leading kind of a healthy and long life. And so genomic based medicine is just a cornerstone throughout that life journey. And is, I think, one of the most exciting promises for both improved quality of care and cost of care. And that combination is just really compelling.

Saul Marquez:
Yeah. And and also the idea of folks of, you know, not only your lifespan but your health span and how can you take a look at the information available with the technologies that that are available to live a healthier life? That's what it's all about. So what would you say you're most excited about today? What what project are you most excited about?

Lisa Alderson:
Well, we are investing heavily in the build out of our genomic care delivery platform. And that is exciting because it brings innovation and how we think about delivering genomic based services. So my prediction for the future is that it's very clear we're moving to a world and it's not in the too distant future. I would estimate three to five years under which every cancer patient receives genomic based medicine, both germline genetics, which means the DNA we inherit from our parents and somatic cell profiling the tumor to better understand selection of therapy. And we see cardiovascular disease moving in that direction, although probably a five to 10 years lagging in terms of adoption of genomic based medicine. And recently, the American Society of Breast Surgeons has recommended genetic testing for all breast cancer patients when previously it was just for those diagnosed with cancer at an early age or with a strong family health history. And so we can I can kind of see how the dominos are falling and moving in that direction. And that, to me is very exciting. You know, using cancer as as one segment and as I've noted, we actually support six different specialty areas, but it's probably the area of medicine where the medical management guidelines and reimbursement coverage is strongest. And then the second area is really around reproductive health. So every pregnant woman generally qualifies under insurance for a carrier test. And we would argue that ideally that should come in come into consideration much earlier in the process before conception as it creates the highest opportunity for a healthy child. And ultimately navigating to the optimal outcome for four for, you know, for that couple. And so so both of those to me are very exciting opportunities. Roughly one out of every 50 children born today is actually affected by a genetic condition. And that can be very severe and life threatening or that can be. A more mild impact, but one out of 50. I mean, that's a very high rate. And again, we have the medicine, we have the science, we have the technology to improve that. We just need to get it into the hands of patients and clinicians.

Saul Marquez:
Love that. And so call the action, folks. Learn a little bit more about this. Find out how you can get engaged. Lisa, if the folks want to learn more. How did they get in touch with you or your team?

Lisa Alderson:
Certainly. So first you can go to our website, genomemedical.com. You can sign up for lying for a clinical console right there and we take insurance. We also have low cost, just patient pay if you want to pay out of pocket. And you know, my recommendation is always that individuals just ask themselves. You know, first, is there a family history of disease in their family that has a genetic cause? And often people don't even know which conditions are inheritable. And so that's an important question. The second key question is just, are you missing family history? Have you, you know, are you adopted? Are you from a small family? There's some cultures where, you know, talking about your medical conditions is not, you know, really part of society. And so often people just don't know. Well, now we can test for family history. So if you don't have a known family history, genetic testing can actually be the answer to help understand what that history looks like. And you know, and then then lastly, like, are you thinking of having children? Are you on multiple medications? Do you have a personal history of of disease or chronic conditions that might have a hereditary basis? All of those are items that, you know, a genetic counselor can navigate you through and help you first understand whether or not genetics might be informative for you, whether or not it's covered by insurance the test itself and then ultimately navigate you towards optimal outcomes. And roughly one out of every six adults is estimated to have a moderate risk variant for which there may be active surveillance or preventive options. One out of six. So really, you know, I always encourage whether it be through visiting genomemedical.com or, you know, visiting your local provider. But I do strongly encourage you to be informed and understand how your DNA can be important for your ongoing health and wellness.

Saul Marquez:
Well, I think that's a great call to action the sun. You know, I think a lot of there's a lot of folks out there that have been curious, you know, and they've done their their genetic or that, you know, there they're twenty three and me, for example, you know, and you get all this like raw data. But what do you do with it? Right.. And so I love that that you're on today to give all of us an option. And so I'll definitely be taking a look at that. You know, I'm one of those people. I took my test and I just haven't done anything with it. And I feel like I should.

Lisa Alderson:
Yeah, definitely. We can help you with results. We can also guide you to, you know, whether or not you've had a comprehensive test. And, you know, not all tests are created equal. There's over 60,000 out on the market. And so many of the consumer oriented there are a great first step. But there, you know, just a little bit of information relative to what may be important for your personal health. And so when I when I think about it the way I like to position it, as you know, frankly, clinicians have a challenge keeping up with what test is right for the patient and for the patient to be able to navigate to that optimal outcome. You know, it is quite complex. And so certainly having a genetic specialist stand your sore on your side can can help with navigating that that challenging environment.

Saul Marquez:
You guys are way finders, Lisa.

Lisa Alderson:
That's exactly it.

Saul Marquez:
And it's critical. So folks take action. Follow up. And in the show, notes outcomesrocket.health type in Lisa Aldersen in the search bar and you'll see the entire transcript links to get in touch with her and the company. So getting to the end here, Lisa. What book would you recommend to the listeners?

Lisa Alderson:
So, you know. Well, one, I just picked up a cure within which I'm just starting. But it's a really interesting story about immuno oncology and how scientists are pioneering, you know, kind of a new field of medicine where we can unleash the immune system to better treat cancer. And so that that's a recent book that I'm excited about. You know, the other one that I often like to point to is that there's a whole series of books by Eric Topol. An interesting read about the need for innovation in health care, and a few of these are deep medicine. How artificial intelligence can make health care human again. One title, which I think is really clever. The patient will see you now, which is really about the empowerment for the patient and then the creative destruction of medicine and how the digital revolution will create better health care. So anyway, those are those are a few that I would mention.

Saul Marquez:
Love it. Yeah. Eric Topol is definitely a go to and appreciate those recommendations before we conclude Lisa, I'd love, if you could just leave the listeners with a closing thought and then we could say goodbye.

Lisa Alderson:
Great. Well, one just. You're empowered to take control of your own health. And now genetics and genomics is one of the building blocks to move towards precision based medicine. So I encourage you to take action on that. And then lastly, I would just say you can follow us on Twitter. Genome Medical is @GenomeMed and you can follow me personally, @LisaA. So thank you for the time today.

Saul Marquez:
Hey, Lisa. Appreciate your insights. And folks, take action on this. I mean, it's an incredible age that we're in and Lisa and her team are doing outstanding work to help us all. So, Lisa, thanks again.

Lisa Alderson:
Thank you, Saul. I appreciate it.

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