Raising Health

Todd Park, former CTO for President Obama, and others discuss the shift from fee-for-service to value-based healthcare. They explore the role of technology, the business model for creating value, and the impact on doctors, patients, insurers, and policymakers.

In this episode, we share an episode of the brand new a16z Live podcast feed called “It’s Time to Heal”—a live conversation on audio/drop in chat app Clubhouse every Monday at 5pm PT, covering the latest trends and future of bio and healthcare with special guests and entrepreneurs, hosted by a16z bio partners Vineeta Agarwala, Jorge Conde, Vijay Pande, and Julie Yoo. Last week, a16z Bio General Partners and a16z cofounder Marc Andreessen talked with guest Nihkil Krishnan, comedian and author known for his Out-of-Pocket Substack newsletter and Slack community for healthcare builders, award winning children’s book, If You Give a Mouse Metformin, and past endeavors at TrialSpark and as healthcare analyst CB Insights. The conversation is all about the things that make you go “hmmm” in healthcare—the stuff we're all thinking but don't talk about, the places where exciting and surprising things are happening, and the places where you have to wonder why it works that way. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

Ticks are master manipulators of our skin, evolving tools in their saliva to feed on hosts and spread diseases like Lyme. The podcast discusses the dynamic host-pathogen interactions, how ticks acquired antibacterial genes, the evolution of tick genes, and unconventional research approaches in academia.

There's been a lot of talk (including on this show!) about the many kinds of innovations and technologies changing healthcare delivery for clinicians and patients. But what's happening behind the scenes in healthcare: in billing, in administration, and infrastructure? In this episode, we’re talking about the mountains of work (and paperwork) in the healthcare system, from reimbursement claims to patient registration to call centers scheduling appointments and much more—the enormous cost of inefficiency and waste in these areas adds to the healthcare system, and what kind of tech can help to improve it. Former Senator Bill Frist—a surgeon, Senate Majority Leader from 2003 to 2007, co-founder of Aspire Health, host of healthcare podcast A Second Opinion, and board member for many healthcare systems and companies; Malinka Walaliyadde, CEO and co-founder of Alpha Health, a tech company that automates healthcare revenue cycle management; and a16z General Partner Julie Yoo join Bio Eats World host Hanne Winarsky to discuss how innovation happens in healthcare's administrative "back office". The conversation covers what that waste currently costs us on a national and personal level; how (and what) new technologies like artificial intelligence and machine learning can automate to help cut cost out of the system; and how ultimately, we can allow innovate in these areas to allow the humans to do the really important work. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

"Superbug" is shorthand for multi-drug resistant bacteria. Infections with superbugs are the most difficult to treat, because these bacteria have evolved ways of evading multiple — and sometimes all! — of our available antibiotics. This multi-drug resistance can arise in the bacteria that are causing disease, meaning doctors have to find new ways to treat the infection, but also in the bacteria that harmlessly live in our gastrointestinal tract. Critically, if these gut bacteria become superbugs, they can spread resistance throughout a hospital setting via fecal-oral contamination. On this episode of the Bio Eats World Journal Club, we discuss a new strategy for protecting those harmless bacteria from antibiotics while still treating the infection. Host Lauren Richardson (@lr_bio) is joined by Professor Andrew Read of Penn State University to discuss his team's work preventing resistance evolution by repurposing an old, FDA-approved drug. The conversation covers the scope of the antibiotic resistance problem, the insights that lead to the discovery of this adjuvant therapy, and the fundamentally novel nature of anti-evolution drugs.  Andrew Read, Ph.D is the director of Huck Institutes of the Life Sciences, the Evan Pugh Professor of Biology and Entomology, and the Eberly Professor of Biotechnology at Pennsylvania State University. He joins host Lauren Richardson to discuss the results and implications of the article "An adjunctive therapy administered with an antibiotic prevents enrichment of antibiotic-resistant clones of a colonizing opportunistic pathogen"  by Valerie J Morley, Clare L Kinnear , Derek G Sim, Samantha N Olson , Lindsey M Jackson, Elsa Hansen, Grace A Usher, Scott A Showalter, Manjunath P Pai, Robert J Woods, and Andrew F Read, published in eLife. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What the heck is "junk DNA"? In this episode, a16z General Partner Jorge Conde and Bio Eats World host Hanne Winarsky talk to Professor Rick Young, Professor of Biology and head of the Young Lab at MIT—all about "junk" DNA, or non-coding DNA. Which, it turns out—spoiler alert—isn’t junk at all. Much of this so-called junk DNA actually encodes RNA—which we now know has all sorts of incredibly important roles in the cell, many of which were previously thought of as only the domain of proteins. This conversation is all about what we know about what that non-coding genome actually does: how RNA works to regulate all kinds of different gene expression, cell types, and functions; how this has dramatically changed our understanding of how disease arises; and most importantly, what this means we can now do—programming cells, tuning functions up or down, or on or off. What we once thought of as "junk" is now giving us a powerful new tool in intervening in and treating disease—bringing in a whole new category of therapies. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

Today we are revisiting a topic and episode that was originally aired back when Journal Club was part of the a16z podcast. We are covering it again in light of a new research article published in Science, as both this episode and this newer research article are trying to find a way to kill senescent cells.The article we discuss in this episode, "Senolytic CAR T cells reverse senescence-associated pathologies" by Amor et al, published in Nature, selectively targets senescent cells with engineered T cells.The new article, "Senolysis by glutaminolysis inhibition ameliorates various age-associated disorders" by Johmura et al, published in Science, kills senescent cells by inhibiting an enzyme essential for their metabolism.So what are senescent cells, and why is killing them so important? Senescent cells are those in a non-dividing but metabolically active state, and what’s interesting is that they play both protective and pathological roles in the body. When senescent cells accumulate, as often happens during aging, they kick off an inflammatory process that underlies many age-related diseases. Thus the targeted destruction of senescent cells has the potential to treat a wide range of conditions, and possibly to improve longevity.Both of the approaches described in these two articles have their pros and cons, and it remains to be seen which will be effective in humans, but together they highlight the interest and importance of senescence-killing, or senolytic, methods for future therapeutics. On this episode, a16z general partner Jorge Conde (@JorgeCondeBio) and bio deal team partner Andy Tran (@andy23tran) join host Lauren Richardson (@lr_bio) to discuss the results and implications of the article "Senolytic CAR T cells reverse senescence-associated pathologies" by Corina Amor, Judith Feucht, Josef Leibold, Yu-Jui Ho, Changyu Zhu, Direna Alonso-Curbelo, Jorge Mansilla-Soto, Jacob A. Boyer, Xiang Li, Theodoros Giavridis, Amanda Kulick, Shauna Houlihan, Ellinor Peerschke, Scott L. Friedman, Vladimir Ponomarev, Alessandra Piersigilli, Michel Sadelain & Scott W. Lowe, published in Nature.The introduction also references the article "Senolysis by glutaminolysis inhibition ameliorates various age-associated disorders" by Yoshikazu Johmura, Takehiro Yamanaka, Satotaka Omori, Teh-Wei Wang, Yuki Sugiura, Masaki Matsumoto, Narumi Suzuki, Soichiro Kumamoto, Kiyoshi Yamaguchi, Seira Hatakeyama, Tomoyo Takami, Rui Yamaguchi, Eigo Shimizu, Kazutaka Ikeda, Nobuyuki Okahashi, Ryuta Mikawa, Makoto Suematsu, Makoto Arita, Masataka Sugimoto, Keiichi I. Nakayama, Yoichi Furukawa, Seiya Imoto, Makoto Nakanishi Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What are the fundamental principles that govern the physical world around us, and how did we get to them? In this episode, Bio Eats World hosts Hanne Winarsky and Lauren Richardson talk to Nobel prize-winning physicist Frank Wilczek about the essential principles of modern physics that have built our understanding of the world. Wilczek (who won the Nobel in 2004 for the discovery of asymptotic freedom in the theory of the strong interaction) dives into not just the principles of physics themselves—around space, time, fields, energy, and the laws that govern them—but the key intellectual driver that brought us to them, which he calls "radical conservatism", or the idea of pushing every theory to its limit. In this wide-ranging, philosophical conversation, Wilczek tells the stories of how certain key theories moved from ideas to principles, from cosmology to complementarity; how the complexity of biology arises from the simplicity of physics; what lead to the discovery of dark matter and axions; whether time can be reversed; what the future of the universe might look like; but most of all, how we as humans attempt to understand the beautiful, complicated world around us. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

Move over microdosing, there is a new approach to psychedelic medicine. Psychedelics — like LSD and psilocybin — are some of the most powerful drugs that affect our brains, but their therapeutic potential has been limited due to their adverse side effects. This is where the work of today's guest, Dr. David Olson (@DEOlsonLab) of UC Davis, comes in. He talks to host Lauren Richardson (@lr_bio) about his lab's effort to develop new drugs based off the structure of psychedelics that retain their therapeutic properties, but that have better safety profiles, and that importantly, are non-hallucinogenic. The conversation covers his team’s recent Nature paper creating a non-hallucinogenic derivative of ibogaine, the evidence from animal models of its ability to treat depression and alcohol- and heroin-seeking behaviors, and the unexpected challenges facing the psychedelic medicine field. David Olson, Ph.D, Assistant Professor at the University of California, Davis, joins host Lauren Richardson to discuss the results and implications of the article "A non-hallucinogenic psychedelic analogue with therapeutic potential" by Lindsay P. Cameron, Robert J. Tombari, Ju Lu, Alexander J. Pell, Zefan Q. Hurley, Yann Ehinger, Maxemiliano V. Vargas, Matthew N. McCarroll, Jack C. Taylor, Douglas Myers-Turnbull, Taohui Liu, Bianca Yaghoobi, Lauren J. Laskowski, Emilie I. Anderson, Guoliang Zhang, Jayashri Viswanathan, Brandon M. Brown, Michelle Tjia, Lee E. Dunlap2, Zachary T. Rabow, Oliver Fiehn, Heike Wulff, John D. McCorvy, Pamela J. Lein, David Kokel, Dorit Ron, Jamie Peters, Yi Zuo & David E. Olson, published in Nature. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Genetic testing is on the cusp of a major revolution, which has the potential to shift not just how we understand our risk for disease, but how we practice healthcare. In the clinic today, genetic testing is used only in cases where we know that mutations have big impact on physiology (BRCA mutations in breast cancer, for example). But our knowledge of how our genetics influences our risk for disease has evolved, and we now know that many (tens of thousands to even millions) small changes in our genes, each of which individually has a tiny effect, combine to influence our risk profile. This new appreciation — coupled with powerful statistical methods and massive datasets — has fueled the creation of a new tool to quantify the risk of a broad range of common diseases: the polygenic risk score. On this episode, host Lauren Richardson (@lr_bio) is joined by Dr. Peter Donnelly, (@genemodeller Professor of Statistical Science at the University of Oxford and the CEO of Genomics PLC,) and Vineeta Agarwala, (@vintweeta physician-scientist and general partner at a16z), to discuss these scores and how they can reshape healthcare, away from a paradigm of treating illness and towards prevention and maintenance of health. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.