Inheret CEO and Founder Dr. David F. Keren talks about the origins of the cancer risk detection platform and his mission to identify hereditary diseases early.
Why did you start this company?
We started Inheret because it’s something that was needed. Here in the United States, 60 million people have a family history that puts them at risk for hereditary cancer—that’s about 1 in 5 people. But too often, these cancers aren’t found early enough because patients don’t know they are at risk and don’t get tested. There are so many tragic stories of people in their 20s and 30s who, sadly, have bad outcomes from a cancer diagnosis that could have been prevented or treated early.
About nine years ago, I had someone reach out to me asking if I could look into this problem an insurance company had in Michigan. Their concern was that doctors weren’t following clinical guidelines when ordering molecular testing, such as for BRCA for breast cancer risk, which was new at the time.
They gave me a grant to talk to physicians in Michigan to find out what was going on. Over the course of that year, I learned from healthcare practitioners that it was an issue of time: Primary care physicians only get 10 to 15 minutes to meet with patients, which are spent caring for other problems like high blood pressure and diabetes. They don’t have time to take extensive family histories that flag the need for genetic testing. In many places, genetic counselors are not available, or their waitlists are several months long, compounding the barriers for these physicians.
So, we set out to develop a mechanism to collect a detailed family health history that wouldn’t take time from providers and would also link to current guidelines so that doctors could refer at risk patients for genetic counseling and order appropriate testing. Together, our team worked on a prototype for an online tool that patients could self-complete to map out their family histories. Over the years, we have continued to improve and refine this tool.
What specific need are you seeking to address in healthcare?
We want to empower individuals to accurately identify their risk for hereditary conditions and give providers the information they need to ensure that their patients have access to genetics. Ultimately, the goal is to remove the burden of cancer risk assessment so that more patients are offered appropriate screening both for common neoplasms such as breast or colon cancer and less common ones such as melanoma and pancreatic cancer.
We emphasize the importance of the patient’s family health history. During our focus group research, many people told us that they feel as though they give their doctors the same information repeatedly, and it just gets stored into their records and forgotten. After a while, it can make a person less willing to answer those same questions if they feel like it doesn’t matter.
Plus, as many of us know, when you’re in the waiting room anxious about your appointment for your immediate health problem, the last things you’re thinking about are diseases your aunt or uncle had. We want people to know that the act of building their family health history gets the time and consideration it deserves and that the data obtained will be used to decrease their chances of developing cancer and other familial conditions.
What does your product do? How does it work?
Individuals are invited to create an account with Inheret via text or email by their provider or employer. When that person clicks on the link, it takes them to our secure, HIPAA-compliant, website. From there, they’ll answer an easy-to-follow questionnaire asking about their personal and family health history. Once that’s finished, they have a complete family health history map to keep with them along with strategies and recommendations based on national best practice guidelines. Each year, Inheret sends them a link to update their health history information so that it can be used against the changes in guidelines to produce an up-to-date report.
Behind the scenes, the individual’s information goes through a risk analysis algorithm evaluating relevant issues, including ethnicity and the age at which family members developed cancer. For participating clinics, physicians are automatically notified when a patient’s family history is submitted and whether it warrants genetic counseling or genetic testing according to the National Comprehensive Cancer Network and other best practice guidelines.
Individuals have the option to share their family history and Inheret report with additional providers or family members.
Is this your first healthcare startup? What’s your background in healthcare?
Well, yes and no. I started as a professor of pathology at the University of Michigan where I worked on tests for immunologic and neoplastic diseases. After a decade of service with them, I was offered the opportunity to serve as the medical director and CEO of a medical reference laboratory that had recently been established. I didn’t deal with the interesting challenges of getting something like this off the ground. But I did help grow that company from a few local hospitals to more than 100 sites in 19 states. After 22 years in that role, I retired and came back to the university to teach part-time—and that’s when this opportunity to start Inheret came about.
What is your company’s business model?
Our business model is threefold. The main revenue engine involves selling individual licenses to healthcare providers, who can then enroll an unlimited number of patients. Secondly, we work with large companies interested in reducing healthcare costs for their workforce while keeping employees happy and healthy. For them, we charge a fee-per-employee as negotiated by the employer size. And finally, we offer labs the opportunity to be listed on ourto integrate on the Inheret platform website to streamline the test ordering process for physicians.
Do you have clinical validation for your product?
We do. One study presented a year ago at the meeting of the National Comprehensive Cancer Network found a 100 percent accuracy rate when genetic counselors manually reviewed cases analyzed by our digital tool—and more than 8 in 10 patients reported that the tool was easy to use. Meanwhile, the time from request to submission of family histories went from four to six weeks to just 72 hours at a genetic risk assessment clinic, and the center’s 400 backlogged patients were completely cleared. But most importantly, the tool newly identified 44 high-risk patients in a primary care clinic who could then take actions to manage their risks. Another study published in the Journal of Clinical Oncology found similar results.
Operationally, we’ve also researched the return on investment for health centers—finding that for each patient deemed high risk, the Inheret tool generates $6,800 in added value from preventive care billable revenue from lab work, imaging studies, and risk-reducing treatments and surgeries.
Finally, we have a paper accepted for publication in the Journal of the National Comprehensive Cancer Network. In that study, we analyzed about 2,000 patients from a genetics clinic and primary care clinics to determine how effective our tool was at identifying cases in need of genetic evaluation. In the genetics clinic, more than 85% of patients completed Inheret and 79% of female patients and 66% of male and non-binary patients met criteria for referral for genetic evaluation. In the primary care setting, 59% of patients completed Inheret and 49% of these patients met referral criteria. These were established primary care patients who had not previously been identified as at increased risk, enabling them to take advantage of preventive care options that could reduce their cancer risk by as much as 96%.
To learn more about how Inheret identifies risk for hereditary cancers of the breast, ovaries, skin, thyroid, colon, and more, visit its website.
Photo: SusanneB, GettyImages