The phrase, “the art of medicine,” has bothered me for many years. With technology already at the forefront of medical discovery, and improving everything else in our daily lives, why do people still die from treatable conditions? Why haven’t we applied the same scientific principles that have led us to understand the evolution of the cosmos, weather patterns, particle physics, or planetary motion to the human body?
When Life Gives You Lemons…
I recall standing in my office in San Francisco years ago, waiting for an update to a mobile analytics platform my team had built, the second largest of its kind in the world at the time, with hundreds of millions of active users all on their cell phones, all over the world. It became clear to me that for the first time in human history we could begin to measure and quantify human behavior. At that moment I felt I was witnessing the transformation of sociology from an art, left to academics, to an information science.
I’d finished early on a dual degree program in Computer Science and Physics, mostly because I had been told it was impossible (the single best way to get my attention), and had consequently spent my post-college years starting tech companies that solved problems ranging from network security to consumer lending, punctuated by chunks of time off to recharge by skiing in remote places. The master plan, despite my father’s insistence on an MBA, was to move to Wyoming and spend the rest of my life chasing winter, but something I could never have imagined derailed those plans.
In June 2008, I was clipped by a car while training for an Ironman. The impact dislocated and shattered my left hip and cracked my pelvis. I also tore muscles off of my right elbow, and a quadricep off my right knee. I had massive internal bleeding, could only move my left arm, and spent much of the year bedridden. At one point I was told I had advanced avascular necrosis in my hip and if I didn’t get a replacement I would lose my leg. I was able to avoid a hip replacement, but still required major surgery after dealing with months of conflicting diagnoses, and struggled to get hospitals to share information about my body, which delayed my recovery.
On top of this health crisis, the driver who hit me was uninsured, and my insurance company refused to pay for the critical care I needed, pending an investigation. The financial crisis of 2008 compounded these problems, and I was forced to sell my house and everything else I owned in order to cover the hospital bills. In three short months, once in great health and financially secure, I found myself unsure of everything: I didn’t know if I’d be able to walk again, let alone live the life I imagined, and I was broke.
What I did have, however, was a front row seat to the complexities of both the finance and healthcare systems, and the better part of a year in a hospital bed to consider how some foundational concepts in both needed to change. My reimagining of the lending industry ultimately led to the creation of Affirm but rethinking healthcare presented a more interesting, complex problem. As an athlete, dedicated to my own health, I found it bizarre that not one doctor could determine what had changed in my body due to the accident, and efficiently assess my condition and treatment plan. But as a scientist, I wondered why there wasn’t a tool with which to comprehensively know the state of our health on a regular basis — not just when we’re sick or confined to a hospital bed, but all the time, and perhaps even before small problems become big ones.
Building the Q Bio Platform
In 2015, Q Bio was born, and we set about to first consider these key principles:
1. Why We Measure, What We Measure, and How
Every person reading this will get sick or injured; it’s inevitable. Our concern should be making sure when this time comes that our doctors have the best tools/information available to determine the cause of the issue, when time is of the essence. The most valuable thing to know at this time is simply what has most recently and significantly changed. This isn’t screening, this is preparing for something inescapable, and we call it “health monitoring”. With this in mind, we designed first platform able to comprehensively measure and identify clinical changes in human biology, associated with common causes of death. In less time than it takes for an average dental visit, Q Bio measures thousands of genetic, biochemical, and anatomical biomarkers. Our platform then continuously aggregates and analyzes a person’s medical history, looking for relationships between past or recent health events and changes in a person’s body that may increase risk. Ensuring this process is non-invasive and fast is critical so that it can be done regularly and reproducibly. We believe this is the physical exam of the future.
2. Clinical Value and Actionability
A research team including Dr. Michael Snyder, one of Q Bio’s founders, studied a group of more than 100 patients for up to eight years, measuring data on them every quarter. During the study, the researchers discovered more than 67 potentially serious health issues, which would not have been discovered as early, if at all, without this level of data analysis over time.
It’s simple but true: every human body is different, and even genetic twins make decisions over the course of their lives that make their risk profiles diverge. The best way to know if there is an issue emerging in your body is to compare you to you. Most diseases are accelerating processes, so assessing health risk on an individual level based on what is changing and how fast will yield insights about the progression of disease far better than comparing single measurements about you today with outdated, unrepresentative population references.
At Q Bio, we believe firmly that this tool can dramatically affect the outcomes of your healthcare decisions for the rest of your life.
In order to make sure there is clinical value in the Q Exam, we consider every biomarker we measure with two specific characteristics in mind:
- How well it can be reproducibly measured
- Existing clinical evidence relating a biomarker to specific health issues
While we are excited about all the research going into the discovery of new biomarkers and tools to measure them, many of them do not sufficiently satisfy these criteria, which we think are critical in order to make information actionable for clinicians and increase confidence in clinical decision making. So we have focused on making better use of existing biomarkers to make sure we are providing immediate actionable value to our users and partners, while continuously evaluating and integrating the latest biomarkers into the Q Exam as they are ready for clinical use.
Actionability is an important characteristic of clinical information, but there is a difference between actionability and clinical intervention. Having actionable information also means knowing when the best course of action is to do nothing. Too often in our health care system do we intervene with drugs or procedures due to a lack of good information and then do limited follow-up to gauge if that intervention not only had its intended effects, but to make sure it didn’t have any unintended side-effects.
3. Empowering Doctors with More Information Requires New Tools
An important part of our mission is to build technology that makes doctors more effective, so that they can spend more time with their patients who need it most.
Today, a single physician can see about 2,000 patients a year and has an average of 15 minutes to spend with each, a significant amount of which is spent logging opinions into an EHR. Highly skilled labor is an increasingly scarce in today’s healthcare system, and this is an ineffective use of their time. If we want preventive healthcare to be available to a growing population, we either need to make more doctors, faster, or doctors need to spend less time with each patient on average. In other words, we need to give doctors the tools so that they can focus more time on people who need it most, and less with those who don’t.
To this end, we designed the first platform able to quickly sift through vast amounts of information and surface the most relevant clinical chemical and anatomical changes in a person’s body broken down by the major subsystems, weighted by their genetic, medical history and lifestyle risks. This removes the obligation to pore through EHRs, which are designed for billing and administration, not to help a doctor understand the dynamic factors impacting someone’s health. Allowing doctors to quickly find emerging issues and identify individuals who have no major immediate risks saves time.
4. Empowering Individuals
The rise of wearables, smart scales, etc. is driven by the underlying desire of people to have better access to and control over information about their bodies. Ironically, the vast majority of this information isn’t clinical quality and cannot be easily used by healthcare professionals in their decision making. Q Bio is the obvious next step in empowering people, not just with more information, but better information, with actual clinical utility so that it can be incorporated into their care. For the first time ever, Q Bio gives people complete control over this information and with whom they share it, making slow, painful processes like second opinions, or re-testing things of the past.
That’s what we are all about at Q Bio. There is growing evidence that a data-centric approach to healthcare will lead to better outcomes. We have the technology to comprehensively measure the human body, tracking clinically relevant and measurable biomarkers for individuals. We have built the software that, with today’s computing power, can analyze the data, and see trends over time, and give that information to individuals and their physicians in an actionable way, as defined by a higher standard.
The Paradigm Shift
We can change medicine from art to science. We can empower doctors to take better care of more people and give patients the efficiency and privacy they need. We can build a healthcare system that does far more than screen for disease and react to problems once they’re existential. It’s a fundamental transformation of medicine that we can and must make.
That’s why we built the foundation for the Science of Medicine; the first platform ever designed to comprehensively and efficiently monitor changes in human health.
Jeff Kaditz, Q Bio CEO and Founder