Uber for tissue banking

PUBLISHED ON  November 22, 2014

WRITTEN BY  Roni Zeiger

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  • Roni ZeigerThe wonder of humanity in one sentence: “My magic potion would be for communities to have meaningful, heartfelt projects that speak to their grief and vulnerabilities.” ,
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Soon, might a courier from Uber show up to the operating room to take your cancer tissue?

I’ve been learning a lot about how important tissue is for many cancer patients. In this era of molecular medicine, it’s often more important to know what mutations your cancer has (e.g. ALK positive) than what organ it happens to be in (e.g. lung cancer). That means a piece of your lung cancer tissue not only needs to be looked at under the microscope, but also tested for mutations. The basic tests we used to run were done — and done well — at every lab, including the one at the hospital where you had your cancer surgery or biopsy. These new molecular tests, however, are evolving quickly. In many cases, you might want a piece of your tumor to be sent to another medical center or a private lab that specializes in molecular testing. Here’s where it gets interesting.


The medical center that performed your surgery or biopsy has your tumor sample, and they are required to send a piece of it to another testing center if you request that they do so. But they don’t have much of an incentive to do this. They might prefer that you get more testing done at their lab or might prefer to keep as much of your tissue as possible for their researchers. Or they simply might not want to invest in making it easy for you to take your “business” elsewhere. This issue is going to get bigger as private testing companies and select medical centers are the ones investing heavily in next generation testing.

So maybe we need a new entity here, which I’ll call Uber for Tissue Banking, or just Uber for short. The incentives for this Uber are set up so that they focus exclusively on:

  • Handling your tissue professionally so that as much of it as possible is preserved for the tests you are most likely to need
  • Sending a sample piece of your tissue, when and only when you request, to the testing center(s) of your choice
  • Upgrading their technology for storing and preserving your tissue in the ways needed by the most current and promising testing centers
  • Alerting you of relevant new testing opportunities
  • Avoiding conflicts of interest, e.g., not setting up exclusive or preferential relationships with any testing centers

I’m not sure if I want Uber handling my tissue anytime soon, but I do think this is yet another area that is ready for some disruption.


PUBLISHED ON  November 17, 2014

WRITTEN BY  Roni Zeiger

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As I gain perspective about life and work, I continue to believe that the world will be a better and richer place if more of us can work at the sweet spot between our passion and our skills. Passion means we are seeking the impact we care most about and we can sustain our effort. Skills means we are serving the area we are most equipped to impact. Two quotes which bring that home for me:

“The word priority came into the English language in the 1400s. It was singular. It meant the very first or prior thing. It stayed singular for the next five hundred years. Only in the 1900s did we pluralize the term and start talking about priorities. Illogically, we reasoned that by changing the word we could bend reality.” — Greg Mckeown in Essentialism: The Disciplined Pursuit of Less

“The way we spend our days is, of course, the way we spend our lives.” — Annie Dillard


Flash mob meets tumor board

PUBLISHED ON  September 16, 2014

WRITTEN BY  Roni Zeiger

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I recently had the privilege of leading a “masterclass” at Stanford’s Medicine X conference. This is one of those situations where you pretend to be an expert, people tell you a bunch of awesome stuff, and then you actually become a bit of an expert. I summarized the current system: researchers invent new drugs, experts give lectures about them, front line clinicians prescribe them to their patients, who do (or don’t) take them in the context of their families and communities.

The question we brainstormed: how might we reconfigure these actors if there were no rules, no laws. Should patients invent new drugs? Should families prescribe treatments? Should communities recruit researchers to work on the problems they want solved?

A few nuggets for me:

  • patients, families, and communities seem to be much better at working as a *team* than the health care system is
  • community not as the source of answers but as a mechanism for putting potential answers in context, the role of community as translator
  • @txtngmypancreas said she might want to collaborate with an inventor, and she’d want to bring her community with her for that collaboration

Which led to this juicy idea: what if whenever doctors or other experts were discussing your case with you, you could instantly invite your community? You could predefine who you ideally want present (two relatives or two hundred community colleagues), give them as much advance notice as possible, and send out the meeting link. They all get to listen. Their questions or comments can go into a queue which a pre-assigned curator from the patient’s community prioritizes for the patient to review in real time, in case she wants to discuss them with the clinical team.

Technically, this is quite easy to build today. Should we?

crowd raising hands