CHICAGO – Following its acquisition of Bavard, a maker of "conversational" artificial intelligence technology, earlier this month, LifeOmic looks far different than the sequencing and informatics company it started out as in 2016.
Indianapolis-based LifeOmic, which once owned two Illumina NovaSeq 6000 instruments to offer whole-genome sequencing to its customers, unloaded its sequencers several years ago to focus on software and services to support precision medicine. A 2017 partnership with Genomenon for clinical trial matching has been dissolved as well, because LifeOmic decided to develop its own software to guide patients toward clinical trials, according to Don Brown, the company's founder and CEO.
Perhaps most significantly, at the beginning of 2021, the company entered the clinical realm after spending its formative years solely on the research side of precision medicine. That was mostly the doing of flagship customer Indiana University Health, which has adopted LifeOmic in its Melvin and Bren Simon Cancer Center, initially for research and now also for finding therapies and clinical trials for cancer patients.
"We had to prove ourselves out on the research side, and things proved so successful there that they moved it over into clinical practice," said majority shareholder Brown, a longtime technology entrepreneur and nonpracticing physician who graduated from Indiana University School of Medicine. For example, a paper published in Cancers last year examined how LifeOmic's technology can support "pre-emptive" pharmacogenetics in breast cancer.
Through the IU Health Precision Genomics Program, the Indianapolis academic health system remains LifeOmic's primary clinical user, though Brown said that the technology is being trialed at the University of Utah and some undisclosed private oncology practices.
Christopher Fausel, clinical manager for oncology pharmacy at IU, said that Precision Genomics Program founders Bryan Schneider and Milan Radovich initiated the collaboration with LifeOmic for various research purposes and worked hand in hand to build the database IU Health uses today. Radovich left last year to become chief precision medicine officer at Caris Life Sciences.
By the beginning of last year, enough IU Health oncologists and pathologists had expressed interest in the LifeOmic database for the organization to bring the technology into clinical practice.
The LifeOmic platform aggregates datasets into the company's data store, called the Precision Health Cloud, or PHC. LifeOmic receives tumor sequencing data — not just laboratory reports — from Foundation Medicine and Caris Life Sciences, the two sequencing labs the IU Precision Genomics Program works with, and combines the results with other clinical and demographic information into the PHC database for analysis.
Fausel, who also serves as chair of the statewide Hoosier Cancer Research Network, uses the LifeOmic cloud to review tumor sequencing reports and to match cancer patients with therapies from LifeOmic's database of approved drugs as well as investigational compounds listed on clinicaltrials.gov. "As I review [each] clinical case, I can look at the clinical [sequencing] report and then go in PHC and look at all the other different variants that showed up, as well as use some of the links in the PHC database to published literature to confirm or refute pathogenicity of individual genomic variants," Fausel said.
The IU Precision Genomics Program is essentially a consultation service, so an oncologist has to request assistance. Physicians can either order a test from Foundation Medicine or Caris Life Sciences and send the result to the Precision Genomics Program for interpretation, or they can ask the program to handle everything. In either scenario, the program turns to LifeOmic for interpretation.
LifeOmic handles the data integration from the sequencing labs to the PHC database and conducts a preliminary review of the genomic information each week to present Fausel with a list of diagnoses and potential therapies the Precision Genomics Program might want to consider. Two LifeOmic data scientists work closely with Fausel in interpreting sequencing results.
In December 2016, around the time LifeOmic started, Brown donated $30 million to establish the Brown Center for Immunotherapy at IU School of Medicine, in part to support precision health. Among other things, that center builds CAR T-cell therapies to treat certain blood cancers. The Precision Genomics Program often works in parallel with that center, identifying targeted therapies based on tumor sequences.
In a typical week, according to Fausel, the program receives results for about 30 patients from LifeOmic on Monday morning, then holds a conference call with the data scientists to discuss sequencing reports and try to match each patient up with either an approved drug or a clinical trial. From Monday at noon until Wednesday at 1 p.m. local time, program officials take a more detailed look at each patient's data, including cancer history and comorbidities, to see how viable each option might be.
During a second call on Wednesday afternoon, the Precision Genomics Program involves other physicians and the two LifeOmic representatives to review recommendations based on the sequencing data and make any necessary changes, which Fausel said are usually "subtle." That second call also helps narrow down the list of patients to about 10 to 12 cases to present to the precision oncology tumor board Thursday at 8 a.m. The rest of the recommendations that don't need to be reviewed by the tumor board are sent back to each patient's care team.
"By the end of the week … we'll have specific recommendations for each one of those patients," Fausel said. "We'll finalize them, and we'll get those in the patient's medical record as a note back to the oncologist who's taking care of them."
Clinical data is moved from IU Health's Cerner electronic health record into the PHC through a Fast Healthcare Interoperability Resources (FHIR) app, but getting genetic data and tumor board recommendations to Cerner requires copying and pasting, as LifeOmic does not directly interface with EHRs, a common issue as precision medicine grows. However, Fausel said that he is talking to IU Health's IT department and LifeOmic about further automating this process.
LifeOmic has been focusing on cancer since its early days but is now trying to move into other domains, including cardiovascular disease prevention. The Precision Health Cloud underlies all of its analytics, including a two-year-old breast cancer research partnership with the IU-developed Susan G. Komen Tissue Bank.
The company has also translated its cloud platform to a corporate wellness system called LifeOmic Precision Wellness that incorporates biomarker and genetic testing as well as medical records, social determinants of health, and behavioral traits. Brown said that LifeOmic has several hundred corporate customers and that the app has been downloaded by 4 million people.
"It gives us a really strong platform for corporate wellness and trying to do the same things: using genomics and other datasets to really try to give people very personalized guidance," Brown said.
The firm has also created a version of its wellness system for postsurgical settings called Precision Recovery.
The acquisition this month of Bavard, a Salt Lake City-based startup that builds enterprise-grade digital assistants to help companies personalize customer support through natural-language processing, is meant to automate customer service for consumers and biomedical professionals alike.
One impetus for the acquisition was LifeOmic's desire to bid on US government contracts. The firm last year received certification from the Federal Risk and Authorization Management Program, or FedRAMP, a government protocol for securing federal data in cloud environments.
According to Brown, there are "severe constraints" on data movement in a FedRAMP zone such as Amazon Web Services' GovCloud. "Yes, we could have used any number of third-party chatbots, but we wouldn't be able to access them from within the GovCloud instance," he said.
LifeOmic is integrating the Bavard AI technology directly into its own platform, but Brown said that the firm will not be looking to license its new asset to other software vendors.
A secondary benefit of having the Alexa and Siri-like digital assistant is more efficient customer service.
"Having that sort of conversational AI capability just makes it easier for us when we sell our products, say, directly to patients or in a corporate wellness setting," Brown said. "Now we can include intelligence with it that can handle maybe 80 percent of patient or end-user questions."
With the Bavard acquisition, LifeOmic now has about 120 employees. The firm is still funded by Brown and some private investors, as well as through revenues.