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Feb 18, 2015 · 21m · mad

Alexander Bisignano, Recombine // Genetic Testing // Data Driven NYC (FirstMark Capital)

Alexander Bisignano · 17m spoken Matt Turck · 1m spoken
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Alexander Bisignano, CEO of Recombine, presents at DataDrivenNYC on how big data analytics, high-throughput genomic testing, and custom algorithms are transforming carrier screening and driving the transition toward personalized medicine.

How this conversation actually went

Every chapter scored 0–10 on four independent dynamics. Hover any point for the reasoning behind the score. Matt holds 6.1% of the talking time here. How this is scored →

Matt as informed peer 0.8 Guest teaching 3.4 Guest disagreement 0.2 Matt pushing back 0.2
05100:0010:0020:000:28–3:59 · Matt as informed peer 0/10 Genetics 101: DNA, RNA, and Digital Storage In this solo presentation segment, the host does not speak, requiring host-side scores to be zero. Bisignano delivers an educational introduction to genetics, framing DNA as the original digital storage medium.3:59–9:16 · Matt as informed peer 0/10 The Genomic Revolution and Big Data Challenges Bisignano continues his monologue on the exponential drop in sequencing costs and the big data challenges in analyzing complex genetic diseases. The host is inactive during this segment.9:16–14:13 · Matt as informed peer 0/10 Case Study: Microarrays and Unknown Unknowns in Genomics Bisignano presents a technical case study on microarray limitations and unknown unknown variants in Canavan disease. The host remains silent throughout the monologue.14:13–18:10 · Matt as informed peer 3/10 Presentation Wrap-Up and Transition to Q&A Matt Turck steps in to moderate, complimenting the presenter before guiding him to explain Recombine's actual product offerings. Turck demonstrates industry awareness by contrasting Recombine's clinical model with consumer-facing 23andMe.18:10–21:33 · Matt as informed peer 1/10 Audience Q&A: Data Sharing, Accuracy, and Industry Adoption Audience members ask about patient data sharing and why legacy testing methods persist despite better technology. Bisignano candidly explains how legacy lab oligopolies and insurance contracts slow industry adoption.0:28–3:59 · Guest teaching 4/10 Genetics 101: DNA, RNA, and Digital Storage In this solo presentation segment, the host does not speak, requiring host-side scores to be zero. Bisignano delivers an educational introduction to genetics, framing DNA as the original digital storage medium.3:59–9:16 · Guest teaching 4/10 The Genomic Revolution and Big Data Challenges Bisignano continues his monologue on the exponential drop in sequencing costs and the big data challenges in analyzing complex genetic diseases. The host is inactive during this segment.9:16–14:13 · Guest teaching 5/10 Case Study: Microarrays and Unknown Unknowns in Genomics Bisignano presents a technical case study on microarray limitations and unknown unknown variants in Canavan disease. The host remains silent throughout the monologue.14:13–18:10 · Guest teaching 2/10 Presentation Wrap-Up and Transition to Q&A Matt Turck steps in to moderate, complimenting the presenter before guiding him to explain Recombine's actual product offerings. Turck demonstrates industry awareness by contrasting Recombine's clinical model with consumer-facing 23andMe.18:10–21:33 · Guest teaching 2/10 Audience Q&A: Data Sharing, Accuracy, and Industry Adoption Audience members ask about patient data sharing and why legacy testing methods persist despite better technology. Bisignano candidly explains how legacy lab oligopolies and insurance contracts slow industry adoption.0:28–3:59 · Guest disagreement 0/10 Genetics 101: DNA, RNA, and Digital Storage In this solo presentation segment, the host does not speak, requiring host-side scores to be zero. Bisignano delivers an educational introduction to genetics, framing DNA as the original digital storage medium.3:59–9:16 · Guest disagreement 0/10 The Genomic Revolution and Big Data Challenges Bisignano continues his monologue on the exponential drop in sequencing costs and the big data challenges in analyzing complex genetic diseases. The host is inactive during this segment.9:16–14:13 · Guest disagreement 0/10 Case Study: Microarrays and Unknown Unknowns in Genomics Bisignano presents a technical case study on microarray limitations and unknown unknown variants in Canavan disease. The host remains silent throughout the monologue.14:13–18:10 · Guest disagreement 0/10 Presentation Wrap-Up and Transition to Q&A Matt Turck steps in to moderate, complimenting the presenter before guiding him to explain Recombine's actual product offerings. Turck demonstrates industry awareness by contrasting Recombine's clinical model with consumer-facing 23andMe.18:10–21:33 · Guest disagreement 1/10 Audience Q&A: Data Sharing, Accuracy, and Industry Adoption Audience members ask about patient data sharing and why legacy testing methods persist despite better technology. Bisignano candidly explains how legacy lab oligopolies and insurance contracts slow industry adoption.0:28–3:59 · Matt pushing back 0/10 Genetics 101: DNA, RNA, and Digital Storage In this solo presentation segment, the host does not speak, requiring host-side scores to be zero. Bisignano delivers an educational introduction to genetics, framing DNA as the original digital storage medium.3:59–9:16 · Matt pushing back 0/10 The Genomic Revolution and Big Data Challenges Bisignano continues his monologue on the exponential drop in sequencing costs and the big data challenges in analyzing complex genetic diseases. The host is inactive during this segment.9:16–14:13 · Matt pushing back 0/10 Case Study: Microarrays and Unknown Unknowns in Genomics Bisignano presents a technical case study on microarray limitations and unknown unknown variants in Canavan disease. The host remains silent throughout the monologue.14:13–18:10 · Matt pushing back 1/10 Presentation Wrap-Up and Transition to Q&A Matt Turck steps in to moderate, complimenting the presenter before guiding him to explain Recombine's actual product offerings. Turck demonstrates industry awareness by contrasting Recombine's clinical model with consumer-facing 23andMe.18:10–21:33 · Matt pushing back 0/10 Audience Q&A: Data Sharing, Accuracy, and Industry Adoption Audience members ask about patient data sharing and why legacy testing methods persist despite better technology. Bisignano candidly explains how legacy lab oligopolies and insurance contracts slow industry adoption.

speaking balance: gold is Matt, purple is the guest (3 minute bins)

0:00 · Matt 0% · guest 100%0:00 · Matt 0% · guest 100%3:00 · Matt 0% · guest 100%3:00 · Matt 0% · guest 100%6:00 · Matt 0% · guest 100%6:00 · Matt 0% · guest 100%9:00 · Matt 0% · guest 100%9:00 · Matt 0% · guest 100%12:00 · Matt 13.3% · guest 86.7%12:00 · Matt 13.3% · guest 86.7%15:00 · Matt 20.3% · guest 79.7%15:00 · Matt 20.3% · guest 79.7%18:00 · Matt 9.7% · guest 90.3%18:00 · Matt 9.7% · guest 90.3%21:00 · Matt 7.8% · guest 92.2%21:00 · Matt 7.8% · guest 92.2%
Sharpest disagreement ▶ 20:55 Critique of legacy lab oligopolies

Bisignano offers his most direct critique, pointing out that incumbents like LabCorp and Quest hold an oligopoly on insurance contracts that impedes superior technology adoption.

 Hardest push from Matt ▶ 14:31 Prompting for the product pitch

Matt Turck gently pushes the presenter to pivot from general educational content to explicitly explaining Recombine's business and primary product.

 Biggest teaching moment ▶ 1:05 Defining DNA as digital data storage

Bisignano educates the audience by explaining how DNA replication naturally satisfies the technical definition of digital storage because copying does not alter the original.

 Matt holds his own ▶ 15:52 Distinguishing B2C vs B2B clinical genetics

Matt Turck shows solid knowledge of the genomics space by citing 23andMe to frame the key distinction between direct-to-consumer testing and physician-guided clinical diagnostics.
the scores for every segment, with the reasoning behind each
ChapterTopicMatt as informed peerGuest teachingGuest disagreementMatt pushing backWhy
Genetics 101: DNA, RNA, and Digital Storage 0400 In this solo presentation segment, the host does not speak, requiring host-side scores to be zero. Bisignano delivers an educational introduction to genetics, framing DNA as the original digital storage medium.
The Genomic Revolution and Big Data Challenges 0400 Bisignano continues his monologue on the exponential drop in sequencing costs and the big data challenges in analyzing complex genetic diseases. The host is inactive during this segment.
Case Study: Microarrays and Unknown Unknowns in Genomics 0500 Bisignano presents a technical case study on microarray limitations and unknown unknown variants in Canavan disease. The host remains silent throughout the monologue.
Presentation Wrap-Up and Transition to Q&A 3201 Matt Turck steps in to moderate, complimenting the presenter before guiding him to explain Recombine's actual product offerings. Turck demonstrates industry awareness by contrasting Recombine's clinical model with consumer-facing 23andMe.
Audience Q&A: Data Sharing, Accuracy, and Industry Adoption 1210 Audience members ask about patient data sharing and why legacy testing methods persist despite better technology. Bisignano candidly explains how legacy lab oligopolies and insurance contracts slow industry adoption.

Statements from this episode (9)

Insight
Bisignano: DNA and RNA represent nature's first digital storage system
“DNA and RNA are the two primary ways of storing information for biological organisms, and it's actually the first digital storage system, which is pretty interesting to think about it from that perspective.”
Alexander Bisignano Feb 18, 2015 ▶ 0:47
Assertion Contradicted
Bisignano: Human genome sequencing costs fell from $3B to $1,000
“We finished the human genome, and then for the next decade, the human genome, the cost to sequence it went from three billion down to 1000.”
Alexander Bisignano Feb 18, 2015 ▶ 4:16
Opinion
Bisignano: Major diagnostic companies Quest and LabCorp lack agile software teams
“Most laboratory diagnostic companies are not set up as software companies. Example, Quest and LabCorp. Two largest companies in the country that do laboratory testing. Twelve billion dollar market cap. They are not agile software teams.”
Alexander Bisignano Feb 18, 2015 ▶ 4:55
Assertion Contradicted
Bisignano: US has one genetic counselor per 250,000 people
“Right now there's about one genetic counselor for every 250,000 individuals in the U.S.”
Alexander Bisignano Feb 18, 2015 ▶ 8:27
Assertion Supported
Bisignano: Most genetic research is based on European and Jewish populations
“Most of genetics actually is based on studying European and Jewish individuals just because that's been the body of literature that's been developed over the past few decades.”
Alexander Bisignano Feb 18, 2015 ▶ 13:02
Assertion Partly supported
Bisignano: Science has not truly sequenced the entire human genome
“We actually haven't truly sequenced the whole human genome just because there's so much variation that we can't capture yet.”
Alexander Bisignano Feb 18, 2015 ▶ 13:49
Assertion Supported
Recombine offers a 250-disease genetic test for under $500 out-of-pocket
“We developed a test that can do 250 of the most common diseases of this nature for under 500 dollars to patients that don't have private insurance”
Alexander Bisignano Feb 18, 2015 ▶ 15:06
Assertion Not checkable as stated
Bisignano: Recombine achieves over 65% patient opt-in rate for research
“We see a 65% or more opt-in from most of the centers”
Alexander Bisignano Feb 18, 2015 ▶ 19:08
Opinion
Bisignano: LabCorp and Quest hold an oligopoly on insurance contracts
“LabCorp and Quest have sort of an oligopoly on insurance contracts, and people tend to stay in network.”
Alexander Bisignano Feb 18, 2015 ▶ 21:02
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