News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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How CRM Systems Help Home Healthcare Providers Treat Patients with Chronic Diseases in a Trend That May Be an Opportunity for Medical Laboratories

Customer relationship management (CRM) plays a critical role in helping providers care for patients with chronic diseases and clinical laboratories are part of those solutions

Home healthcare continues to boom in the US and more technology companies each year—including Salesforce—strive to expand their presence within the industry. This represents a significant shift in site of service for a substantial and growing number of Americans. Equally true is that home healthcare is an opportunity for clinical laboratories to serve this increasing proportion of the American population.

Statistics tell the tale behind the boom in home healthcare. The Centers for Disease Control and Prevention (CDC) estimates that six in 10 adults in the United States suffer from chronic diseases, such as cancer, and four in 10 adults live with two or more chronic illnesses.

This means that among medical laboratories and other providers servicing the home healthcare industry demand for clinical laboratory testing will increase.

Last year, approximately $103 billion was spent on home healthcare services and that number is expected to reach $173 billion by 2026, according to the Centers for Medicare and Medicaid Services (CMS). Approximately 7.6 million people in the US now require some level of in-home medical care. The overall employment of in-home healthcare providers is projected to grow 41% between 2016 and 2026.

Efficient tools that assist home healthcare organizations and their providers are critical. Customer Relationship Management (CRM) platforms that combine data gathered during office visits with patients’ living and economic situations are proving to be powerful allies for treating chronic disease populations.

Social Determinants of Health

One such CRM developer, Salesforce, is rising to the demand by adding new features to its existing Health Cloud platform. Originally introduced in 2016 as a way to improve how healthcare and life sciences organizations connect with patients, this product is one example of how Silicon Valley companies are attempting to make inroads within the healthcare sector. Health Cloud’s newest functional upgrades include:

  • Complete patient profiles,
  • Relevant patient communications, and
  • Connected in-home care.

This includes social determinants of health, such as:

  • Living conditions,
  • Socioeconomic status, and
  • Environmental factors.

These social determinants of health are typically not included in health records. But they can be vital information for healthcare providers. Clinical laboratory managers should pay attention to “social determinants of health” because this term describes a new dimension in medical care and how patients with chronic diseases are managed.


“A lot of people in healthcare know about the importance of social determinants of health, but the volume of information is so great that being able to display things clearly and concisely in front of the [providers who] are using it—when they need it—makes it more operant and more prominent in the care of that patient,” Joshua Newman, MD, Chief Medical Officer at Salesforce, told MedCity News. (Photo copyright: San Francisco Business Times/Biz Journals.)

This is a critical factor. Healthcare providers who use Salesforce’s Health Cloud can now record a patient’s social determinant information—such as, transportation issues, housing status, and care network—directly into that patient’s profile. Access to this type of information can give healthcare professionals a more complete understanding of each patient’s unique situation.

Here are some examples from a Salesforce press release that illustrate how social-determinants-of-health data can help patients and care providers:

  • “A care provider that wants to limit a patient’s risk for readmission can know if the patient has access to transportation or the ability to purchase healthy meals.
  • “A life science organization that wants to help patients adhere to their therapies, or properly use their medical devices, can see a patient’s employment status and living arrangements, and thus offer the necessary level of financial and in-home support.
  • “A payer organization can deliver personalized preventative or wellness material to members based on the member’s education or reading level.”

“Our industry continues to centralize and integrate patient data, but it is critical that we stay focused on improving the patient experience,” noted Ashwini Zenooz, MD, in the press release. Zenooz is Salesforce’s Senior Vice President and General Manager, Global Healthcare and Life Sciences. “By surfacing critical factors of a patient’s life in a single view, we empower care providers to personalize patient care experiences and improve outcomes.” 

Many existing CRM products cannot collect data from a variety of sources and then sort and analyze that information to provide users with actionable intelligence. Salesforce is attempting to fill that void among health and medical software products with Health Cloud. 

“Healthcare has been slower culturally, politically, and socially to share their data. But what we’re seeing now is even those organizations that have historically not shared their data are realizing they can do a better job if they do,” Newman told MedCity News.

Outside Hospital Care Increasing

Salesforce has also added a service it calls the Connected Patient Journey to its Health Cloud platform. This service is an integration between Health Cloud and Salesforce marketing, which can personalize information given to patients based on their unique health needs. Using this feature allows providers to build patient lists and use marketing techniques to reach patients who would most benefit from specific campaigns and information.

“The general overarching theme that unites all of these innovations is that care is gravitating increasingly toward the home or outside of the hospital and the doctor’s office,” said Newman.

Whether in-hospital or in-home, clinical laboratory tests play a critical role in healthcare services. The ability for clinical laboratories to enter patients’ test results data directly into CRM systems like Health Cloud could help providers utilizing those systems better assist patients with chronic diseases.

—JP Schlingman

Related Information:

Salesforce Launches New Healthcare Features to Manage Social Determinants and In-home Care

Salesforce Delivers New Health Cloud Innovations to Personalize Patient Experiences to Improve Outcomes

America’s $103 Billion Home Health-care System is in Crisis as Worker Shortage Worsens

The Rise of Home Health Care

Clinical Laboratories Turn to Healthcare-Focused CRM to Optimize Operations and Increase Market Share, Despite Decreasing Reimbursement

New CRISPR Genetic Tests Offer Clinical Pathologists Powerful Tools to Diagnose Disease Even in Remote and Desolate Regions

Researchers at UC Berkley developed new ways to use CRISPR as a genetic “search engine” in addition to a cut and paste tool

Clinical pathology laboratory professionals have long been aware of the potential diagnostic properties related to CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) technology. Now, new tests using the gene-editing tool show that potential is being realized.

One example involves using CRISPR to detect diseases in Nigeria, where a Lassa fever epidemic has already led to the death of 69 people this year alone. According the journal Nature, this diagnostic test “relies on CRISPR’s ability to hunt down genetic snippets—in this case, RNA from the Lassa virus—that it has been programmed to find. If the approach is successful, it could help to catch a wide range of viral infections early, so that treatments can be more effective and health workers can curb the spread of infection.”

Researchers in Honduras and California are working on similar projects to develop diagnostic tests for dengue fever, Zika, and the strains of human papillomavirus (HPV) that lead to cancer. There’s also a CRISPR-based Ebola test pending in the Democratic Republic of Congo.

These new genetic tests, which may be as simple as at-home pregnancy tests to use, could save many lives throughout the world. They will give medical laboratories new tools for diagnosing disease and guiding therapeutic decisions.

Shift in How Researchers View CRISPR

“We really think of CRISPR fundamentally as a kind of search engine for biology—like Google for biology—rather than [a kind of] word processing tool, although it’s really good at that too,” Trevor Martin, PhD, co-founder and CEO of Mammoth Biosciences, told CRISPR Cuts, a Synthego CRISPR podcast.

Mammoth is a team of PhDs working out of Doudna Lab at UC Berkley, a research laboratory run by Jennifer Doudna, PhD, Professor of Chemistry,

Professor of Biochemistry and Molecular Biology, and Li Ka Shing Chancellor’s Professor in Biomedical and Health.

Martin’s statement represents a shift in how researchers are thinking about CRISPR. At first, CRISPR was seen as a tool for cutting and pasting genetic material. Scientists could tell it to find a target DNA sequence, make a cut, and paste in something different. However, by thinking of the tool as a search engine, CRISPR’s tremendous diagnostic potential becomes apparent.

“This is a very exciting direction for the CRISPR field to go in,” Doudna told Nature.

Martin told CRISPR Cuts that diagnostics is “fundamentally a search problem,” adding, “Now you can program [CRISPR] to find something, and then tell you that result.”

Doudna notes in Technology Networks that, “Mammoth’s technology exemplifies some of the most urgent, impactful, and untapped potential in the CRISPR space.”


Fehintola Ajogbasile (above), a graduate student at the African Centre of Excellence for Genomics of Infectious Diseases in Nigeria, uses a CRISPR diagnostic test to look for Lassa virus in a blood sample. Similar clinical pathology laboratory tests are becoming available in the US as well. (Photo and caption copyright: Nature/Amy Maxmen.)

Investors See Economic Benefits of CRISPR 

The potential financial and economic impact of simple-to-use CRISPR-based diagnostic tools is considerable. Technology Networks notes that the diagnostics market is estimated at $45 billion, and that venture capital firms Mayfield, First Trust Mid Cap Core AlphaDEX Fund (NASDAQ:FNX), and 8VC have all invested in Mammoth Biosciences.

Although the diagnostics market is huge, a critical aspect of the Lassa fever diagnostic test the Nigerian researchers are developing is that it will be as accurate as conventional clinical laboratory testing methods, but much simpler and less expensive.

Dhamari Naidoo, a technical officer at the World Health Organization (WHO) told Nature that researchers often fail to think about the fact that new technology must be affordable for use in low-income countries.

About a dozen diagnostic tests for Ebola have been developed, according to Naidoo, but only two have been used recently in the Democratic Republic of Congo, where the virus is resurging, due to economic concerns. To be useful, medical laboratory tests in low-income countries must be affordable to license and distribute, and critically, the manufacturers must identify a market large enough to motivate them to make and distribute such diagnostic tests.

Future Directions for CRISPR and Clinical Pathology

Researchers first discovered what would come to be known as CRISPR in the early 1990s. However, it wasn’t until 2012 – 2013 that scientists used CRISPR and Cas9 for genome editing, a Broad Institute CRISPR timeline notes.

Now, researchers around the world are finding innovative ways to employ the technology of CRISPR to detect disease in some of the most remote, challenging areas where diseases such as Lassa fever, Zika, and dengue fever among others, have devastated the populations, as Dark Daily has previously reported.

What’s next for clinical and pathology laboratories and CRISPR? We’ll let you know.

—Dava Stewart

Related Information:

Faster, Better, Cheaper: The Rise of CRISPR in Disease Detection

Biology’s Google: CRISPR Diagnostics Are Changing Medicine

CRISPR Diagnostics Could Detect Any Disease on a Paper Strip

CRISPR Timeline

CRISPR-Related Tool Set to Fundamentally Change Clinical Laboratory Diagnostics, Especially in Rural and Remote Locations

University Study Suggests Cervical Microbiome Could Be Used by Medical Laboratories as Biomarker in Determining Women’s Risk for Cervical Cancer

Researchers find presence of “high-grade” precancerous lesions caused by human papillomavirus (HPV) associated with “richness” of cervical bacteria

Could bacteria residing in the cervix of women be useful in screening for cervical cancer? That’s what a study into the connection between human papillomavirus (HPV) infections and the human immunodeficiency virus (HIV) conducted by researchers at the University of Nebraska-Lincoln (UNL) and the Ocean Road Cancer Institute in Tanzania, seems to suggest.

Additional studies will be needed, but if the apparent causality proves out, it could lead to new clinical laboratory biomarkers to help determine women’s risk for developing cervical cancer.

The researchers published the results of their study in mBio, an open-access journal of the American Society for Microbiology.

New Cervical Cancer Screening Biomarker for Clinical Labs, Pathology Labs?

Human gut bacteria (aka, gastrointestinal microbiota, a component of human microbiome) has been at the center of many revolutionary studies in past years, and has been the subject of many Dark Daily e-briefings. But this may be the first instance of the cervical microbiome being thought of as a potential biomarker in cancer screening.

To perform the research, the scientists obtained tissue samples taken from cervical lesions of 144 women who had undergone cervical cancer screenings in various locations throughout Tanzania between March 2015 and February 2016. The researchers then used a technique known as “deep sequencing” to sequence 16 Ribonucleic acid (RNA) genes from the samples.

One hundred and twenty-six of the women tested positive for HPV and 41 tested positive for HIV. In addition, 50 of the women were diagnosed with high-grade lesions that were likely to become cancerous.

And here is where the researchers made their discovery. They found that the “women with the high-grade lesions had a more abundant and diverse microbial mix in their cervical microbiomes than women who had no lesions or less serious lesions,” noted a UNL news release.  

“There are certain families of bacteria that appear to be associated with the higher grades of precancerous lesions,” Lead Author Peter Angeletti, PhD, Associate Professor, Biological Sciences, University of Nebraska-Lincoln, noted in the news release. “What we know so far is that there is a relationship between the virus commonly associated with cervical cancer and the microbiome.”

Peter Angeletti, PhD
Peter Angeletti, Associate Professor, School of Biological Sciences, and Cameron Klein, graduate student in virology, have discovered a link between the HPV (Human papillomavirus) virus and how various bacteria effect it’s growth. February 18, 2019. Photo by Craig Chandler / University Communication

The researchers found that a certain group of bacteria known as Mycoplasma may play a role in the growth of HPV-related cervical lesions. According to UNL, this type of bacteria is known to cause illnesses such as:

It also can be sexually transmitted.

The World Cancer Research Fund (WCRF) lists cervical cancer as the fourth most common cancer occurring in women worldwide and the eighth most common cancer overall.

Cervical Cancer Rates in Sub-Saharan Africa

Nineteen of the top 20 countries for cervical cancer are located in Sub-Saharan Africa. The Centers for Disease Control and Prevention (CDC) reports that about one in four individuals in the US—nearly 80-million individuals—are currently infected with HPV. 

At one time, cervical cancer was the leading cause of cancer deaths for women in the US. According to the CDC, there were 12,845 new cases of cervical cancer reported in the US in 2015, and 4,175 women died of the disease that year. Those numbers correlate to eight new cervical cancers reported per 100,000 women and two cancer deaths per 100,000 women in the US. 

By contrast, in 2018, for every 100,000 women there were 75.3 new cervical cancer cases reported in Swaziland, the country with the highest rates of the disease, according to WCRF statistics.

There were more than 500,000 new cases of cervical cancer reported worldwide in 2018.

However, new cases of the disease and deaths from cervical cancer have decreased significantly since regular Pap smears became a standard test for women in the US.

The findings of this study indicate additional examination of cervical microbiome could result in useful clinical laboratory data for developing diagnostic tests and possible new treatments for cervical cancer.

—JP Schlingman

Related Information:

Cervical Microbiome Could Help Predict Cancer Risk

Relationship between the Cervical Microbiome, HIV Status, and Precancerous Lesions

Link between Cervical Microbiome and Cancer Discovered

Cervical Microbiome May Promote Cancer

Genomic Study Reveals Role of Human Papillomavirus in Cervical Cancer and Identifies Novel Therapeutic Targets for the Disease

Is New Cervical Cancer Test Better Than a Pap Smear?

VA Engages Private Sector Companies in Major Telehealth Initiative to Bring Critical Healthcare Services to Thousands of Veterans Living in Remote Areas

Walmart, T-Mobile, and Philips have partnered with the VA and will be providing key resources that could offer opportunities for local clinical laboratories

In what may prove to be a useful innovation, the U.S. Department of Veterans Affairs (VA) is preparing a major expansion of its telehealth (aka, telemedicine) offerings. What adds interest to this effort is that veterans will be able to access telehealth services in such settings as selected posts run by the Veterans of Foreign Wars (VFW) and American Legion, as well as in some Walmart stores.

Many in healthcare view telehealth as key to bringing healthcare services to outlying, rural, and remote areas that lack critical medical services. And, a new telehealth initiative proposed by the VA could further advance that effort by helping bring the advanced technology into the mainstream healthcare arena.

Dubbed the “Advancing Telehealth through Local Access Stations” (ATLAS) initiative, the goal is to provide veterans living in rural or remote areas with the best possible care. And, of course, many types of healthcare services require clinical laboratory testing. Thus, labs with access to VA patients in remote areas of the country should be looking for opportunities to collaborate with the VA.

Medical laboratory leaders will find it useful to follow the progress of this initiative, because when the VA completes a major project such as this proposed telehealth program, the results often serve as a proof-of-concept that can lead to wider acceptance among Medicare and private insurers of similar projects in the civilian community.

Announced at the VA’s Anywhere to Anywhere, Together summit in Washington DC, the ATLAS initiative involves private sector companies T-Mobile, Walmart (NYSE:WMT), and Philips (NYSE:PHG).

As part of the partnership:

  • Philips will equip 10 VFW and American Legion posts with its telehealth technology;
  • Walmart will dedicate store space and technical support to host VA-led telehealth appointments in select stores across the country; and,
  • T-Mobile will provide 70,000 wireless service lines that will enable veterans to use the VA’s encrypted, secure Video Connect telehealth app without incurring charges regardless of their data plan.

VA Already Largest Telehealth Provider in America

With the 2017 launch of its “Anywhere to Anywhere, Together” program, the VA quickly became the nation’s largest telehealth provider. In fiscal year 2018, the VA held more than one million video telehealth encounters—a 19% increase over the prior year—the VA stated in a news release. Of the one-million plus video encounters, 105,300 were conducted using the VA Video Connect application on mobile devices or home computers.


“VA’s telehealth capabilities are bridging the care gap for many veterans,” stated VA Secretary Robert Wilkie (above) in a VA press release. “This technology gives veterans access to the timely, quality care they deserve, without having to travel great distances to a VA facility. Time spent traveling is time away from veterans’ jobs and families.” (Photo copyright: Veterans Administration.)

At the time of the 2011-2015 United States Census, five million of the nation’s roughly 20 million veterans lived in rural areas.

“[The VA’s telehealth program] totally changes the VA’s footprint for delivering care,” Deborah Lafer Scher, Executive Advisor to the Secretary, Secretary’s Center for Strategic Partnerships, US Department of Veterans Affairs, told the Federal News Network. “We mapped out where our veterans are in greatest concentration against VA facilities, and then we put the Walmart map on top of that. Ninety percent of veterans live within 10 miles of a Walmart. Ninety percent of veterans don’t live within 10 miles of a VA medical center. This totally changes their ability to access care in a way that works for their lives.”

Another appealing aspect of the VA’s telehealth service is its simplicity. According to Becker’s Hospital Review, users can access the service automatically from their personal computers, mobile phones, or tablets by clicking a link sent to them prior to a telehealth encounter.

“Connectivity is that simple: the veteran need not install an app, change their behavior, worry about passwords or administrative rights,” Becker’s notes. “They just connect. Simply. Easily. Moving forward, these efforts will be extended further. Imagine a veteran that is hard of hearing joining a video encounter and getting the settings on [his or her] hearing aid device tweaked on the fly.”

Such advances led VA Secretary Wilkie to declare in his opening remarks at the Anywhere to Anywhere, Together summit, “We are on the cusp of the most transformative period in the history of the Department of Veterans Affairs. Virtual care is the future of medicine. It is our most powerful emerging tool,” the VA’s blog reported.

Regulation a Barrier to Telehealth Adoption

Yet, the road to wide spread use of Medicare/Medicaid telehealth may not be smooth. Law firm Epstein Becker Green in their 2018 Telemental Health Laws Survey found reimbursement and regulatory barriers continue to block widespread adoption of telehealth services.

“Despite Medicaid’s fewer restrictions on telehealth coverage as compared to its Medicare counterpart, there is limited federal guidance or information regarding the implementation of telehealth services in state Medicaid programs or coverage parameters for states choosing to offer such services,” the attorneys stated in a press release.

Becker’s Hospital Review cited other issues slowing telehealth adoption as well, including reliability and accuracy, access, and security. However, Becker’s also highlighted a 2018 Deloitte survey that showed 67% of physicians polled stated that making virtual care technologies more interoperable would lead to greater adoption rates of telehealth services.

As an ever-growing number of veterans receive their healthcare through telehealth services, clinical laboratories and anatomic pathology groups should look for opportunities to collaborate with the VA to provide diagnostic testing services to our great former service men and women.

—Andrea Downing Peck

Related Information:

U.S. Department of Veterans Affairs Partners with T-Mobile to Help Expand Access to Health Care for Veterans

VA Announces Telehealth Partnerships with Walmart, Philips, T-Mobile

T-Mobile to Provide 70,000 Lines of Service to VA to Boost Telehealth

VA’s Telehealth Program is Already the Largest in the Nation. It’s About to Get Bigger

Telemental Health Laws App

Epstein Becker Green Finds Increasing Acceptance of Telehealth Services Among Providers and Legislators

How the VA Is Proving the Power of Telehealth

What Can Health Systems Do to Encourage Physicians to Embrace Virtual Care?

Veterans in Rural American: 2011-2015

President, VA Secretary Announce Veteran Telehealth Initiatives Designed to Provide Greater Access, Care

VA Exceeds 1 Million Video Telehealth Visits in Fiscal Year 2018

U.S. Department of Veteran Affairs and Walmart Announce Telehealth Collaboration to Reach Underserved VeteransTelehealth: Adapting Tech to Improve VA Health Care

Mt. Sinai Hospital and Cactus Design Studio Create 8-Station Clinical/Research Laboratory to Assess Health and Prevent Disease

Lab100 is designed to be easily upgraded with the latest medical laboratory technologies for tracking patients’ health metrics and risk for chronic diseases

Mount Sinai Hospital and Cactus, a New York City-based design studio, are creating a hybrid clinical laboratory/research lab that uses the latest diagnostic technologies to assess peoples’ health, provide them with an overview of their current condition, and suggest lifestyle changes to prevent future diseases.

Though still under development, Lab100 is an innovative approach to modernizing annual physical/medical check-ups. It was created to empower patients to track and understand their own health metrics and optimize their overall health. 

Lab100 looks at an individual’s medical history and measures vital signs, blood analysis, anthropometrics, body composition, cognition, dexterity, strength, and balance. It’s designed to be more extensive than the traditional, annual physical, as well as to support the implementation of preventative measures to avoid disease. 

8-Station Clinical Laboratory Built for Future Expansion

Lab100 consists of eight stations that are built on a reconfigurable grid system that ensures the system can easily be upgraded with new technology as it becomes available.

“By definition, no one knows what the future of healthcare is, and neither do we. We made our best initial guess, recognizing that we’re going to change based on the data we collect,” David Stark, MD, the Director and founder of Lab100, told Business Insider. “It may turn out that we jettison some of these stations and put in additional stations.”

Stark is also Chief Medical Officer, Head of HR Data and Analytics, and Managing Director at Morgan Stanley, as well as being the former Medical Director and Assistant Professor of Health System Design and Global Health at the Institute for Next Generation Healthcare (INGH) at the Icahn School of Medicine at Mount Sinai.


“We’re trying to give patients more visibility, not only into their health, but into how healthcare happens with the hope that that visibility engages them as patients,” David Stark, MD, MS (above), Director and founder of Lab100, told Business Insider. Should Lab100 prove successful, it could become a model for future similar medical laboratories nationwide. [Photo copyright: Business Insider.]

Before visiting Lab100 patients complete a pre-visit assessment consisting of standardized medical surveys including medical history, nutritional habits, physical activity, mental health, and sleep habits. With patients’ consent, individual data are shared with a select group of researchers to potentially power new discoveries.   

Lab100’s eight stations and their purposes are:

  • Station One: A patient’s photograph is taken to put a face with the medical record. The picture also allows researchers to perform more speculative work by extracting facial features and correlating them with health metrics.
  • Station Two: The patient’s vital signs (temperature, height, weight, blood pressure, pulse, and oxygen levels) are taken.
  • Station Three: A venous blood sample is extracted to measure electrolytes, nutrient, and cholesterol levels. Patients do not need to fast for the blood draw. The blood test is analyzed onsite and the results are available within 30 minutes. 
  • Station Four: The patient steps on a 3D full-body scanner where a depth-sensing camera scans the body and creates a high-resolution 3D avatar of the individual.
  • Station Five: A body composition test is performed using bioelectrical impedance analysis. A small electrical current is run through the body to determine the distribution of water, fat, protein, and minerals in the body and to measure how muscle and fat are distributed throughout the body.
  • Station Six: Cognition is analyzed using a traditional pegboard dexterity test. To perform this test, a patient dons headphones and interacts with an Apple iPad to test vocabulary, processing speed, flexibility, episodic memory, and attention.
  • Station Seven: The patient’s overall strength is measured by utilizing virtual reality to determine grip strength and push the patient to give their maximum performance.
  • Station Eight: The patient steps onto a balance pod to test their balance. An iPod with an accelerometer placed around the patient’s waist measures sway as the individual tries to stay as still as possible.   

The entire Lab100 process takes about 90 minutes and is one-on-one between patient and physician. Test results at each of the eight stations are held until the end of the visit where they are cumulatively displayed on a screen for the patient and physician to review. Blood analyses are included in patients’ work-ups. (Photos copyright: Lab100.)

Engaging Patients in Their Own Healthcare

When patients complete their Lab100 experience, they should have a better understanding of their current health and any changes they can make in their lives to improve their health and possibly avoid future disease. The results allow a patient to learn their risks for some diseases and whether interventions—such as changes in diet and exercise—could alter those risks.

“The idea here is not to obsess over every number, but to holistically look at what’s going well, what isn’t going well, and come away with one to three domains that you as the patient want to focus on,” Stark noted.

The initial Lab100 visit serves as a baseline for comparing with future visits to measure improvements as a result of lifestyle changes. It also allows patients to compare their health metrics to others in the same age range.

Lab 100 is still in the testing stages and could be available to the public later this year. It is not intended to be a replacement for primary care and does not diagnose disease. It is intended to serve as a complement to a traditional office visit and focuses on preventative measures to avoid illness. The researchers involved in the Lab100 project hope the environment can ultimately be used to produce new diagnostics, therapeutics, and tools for measuring health.

—JP Schlingman

Related Information:

Later This Year you’ll be Able to Get a Futuristic Medical Check-up at Mount Sinai — We got an Early Peek

Mount Sinai Teamed Up with the Designers Who Created Projects for Nike and Beyonce to Build a Futuristic, New Clinic and it’s Reimagining How Healthcare is Delivered

VIDEO: Lab100 at Mount Sinai: Cactus Case Study

Researchers at Johns Hopkins University Use AI and Human Gut Bacteria to Predict Age of Microbiome Hosts

Clinical laboratories could soon have new tests for determining how fast a patient’s digestive system is aging as part of a precision medicine treatment protocol

When it comes to assessing human age and longevity, much research has focused on telomeres in recent years. Now clinical laboratory managers and pathologists will be interested to learn that provocative new research demonstrates that the human microbiome may also contain useful information about aging. Microbes that can be diagnostic biomarkers may be one result of this research.

From preventing weight loss to improving cancer treatments to stopping aging, human microbiome—especially gut bacteria—are at the heart of many near miraculous discoveries that have greatly impacted clinical pathology and diagnostics development. Dark Daily has reported on so many recent studies and new diagnostic tools involving human gut bacteria it’s a wonder there’s anything left to be discovered. Apparently, however, there is!

Using artificial intelligence (AI) and deep-learning algorithms, researchers at Insilico Medicine in Rockville, Md., have developed a method involving gut bacteria that they say can predict the age of most people to within a few years. Located at Johns Hopkins University, Insilico develops “artificial intelligence for drug discovery, biomarker development, and aging research” notes the company’s website.

According to a paper published on bioRxiv, an online biomedical publications archive operated by Cold Spring Harbor Laboratory, the Insilico scientists have “developed a method of predicting [the] biological age of the host based on the microbiological profiles of gut microbiota” as well an “approach [that] has allowed us to define two lists of 95 intestinal biomarkers of human aging.”


“This microbiome aging clock could be used as a baseline to test how fast or slow a person’s gut is aging and whether things like alcohol, antibiotics, probiotics, or diet have any effect on longevity,” Alex Zhavoronkov, PhD (above), one of the study’s authors and founder of Insilico Medicine, told Science. (Photo copyright: Insilico Medicine.)

Clinical Laboratories Might Be Able to Use AI and Gut Bacteria to Predict Age

To perform the study, the researchers collected 3,663 gut bacteria samples from 10 publicly available data sets containing age metadata and then analyzed the samples using a machine learning algorithm. The samples originated from 1,165 healthy individuals who were between the ages of 20 and 90. The individuals used for the study were from Austria, China, Denmark, France, Germany, Kazakhstan, Spain, Sweden, and the US.

The researchers divided the samples equally among three age groups:

  • 20 to 39 years old (young);
  • 40 to 59 years old (middle aged); and,
  • 60 to 90 years old (old).

The samples were then randomly separated into training and validation sets with 90% of the samples being used for training and the remaining 10% making up the validation set.

The scientists trained a deep neural network regressor to predict the age of the sample donors by looking at 95 different species of bacteria in the microbiome of the 90% training set. The algorithm was then asked to predict the ages of the remaining 10% of the donors by looking only at their gut bacteria.

They discovered that their computer program could accurately predict an individual’s age within four years based on their microbiome. They also were able to determine that 39 of the 95 species of bacteria examined were most beneficial in predicting a person’s age. 

In addition, the researchers found that certain bacteria in the gut increase with age, while other bacteria decrease as people age. For example, the bacterium Eubacterium hallii, which is associated with metabolism in the intestines, was found to increase with age. On the other hand, one of the most plentiful micro-organisms in the gut, Bacteroides vulgatus, which has been linked to ulcerative colitis, decreases with age.  

Understanding Microbiome’s Link to Disease

The human microbiome consists of trillions of cells including bacteria, viruses, and fungi, and its composition varies from individual to individual. Scientific research, like that being conducted at Insilico Medicine, expands our understanding of how gut bacteria affects human health and how diseases such as inflammatory bowel disease, arthritis, autism, and obesity, are linked to the microbiome.

This type of research could be used to determine how the microbiomes of people living with certain illnesses deviate from the norm, and possibly reveal unique and personalized ways to create healthier gut bacteria. It also could help researchers and physicians determine the best interventions, drugs, and treatments for individual patients dealing with diseases related to aging. Such advancements would be a boon to precision medicine.

“Age is such an important parameter in all kinds of diseases. Every second we change,” Zhavoronkov told Science. “You don’t need to wait until people die to conduct longevity experiments.”

Further research is needed to develop these findings into diagnostic tests acceptable for use in patient care. However, such tests could provide microbiologists and clinical laboratories with innovative tools and opportunities to help physicians diagnose patients and make optimal treatment decisions.

—JP Schlingman

Related Information:

This AI Can Tell Your Age by Analyzing Your Gut Microbiome

Human Microbiome Aging Clocks based on Deep Learning and Tandem of Permutation Feature Importance and Accumulated Local Effects

The Bacteria in Your Gut may Reveal Your True Age

Your Gut Microbiome Could Actually Reveal Your Age, Study Shows

University of Illinois Study Concludes Regular Physical Exercise Improves Human Microbiome; Might Be Useful Component of New Treatment Regimens for Cancer and Other Chronic Diseases

Attention Microbiologists and Medical Laboratory Scientists: New Research Suggests an Organism’s Microbiome Might Be a Factor in Longer, More Active Lives

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