Steven Schwartz (00:24)
Hello and welcome to the Concierge Medical Marketing Podcast. I’m your host, Stephen Schwartz. So glad to have you along on our discussion today. I’m really excited to ⁓ introduce you all to Dr. Grant Antoine and his company is Viome. They’re based in Seattle, Washington and have some really exciting ⁓ tech that they’re doing on testing with RNA, but without stealing his thunder, Dr. Grant, thanks for being with me today on the podcast.

Grant Antoine (00:50)
Hey, good morning. Thanks, Stephen. Thanks for having me.

Steven Schwartz (00:52)
Yeah, truly my pleasure. Let’s just jump right in. Please give us some background on yourself, your education, where you grew up and your focus in medicine.

Grant Antoine (01:02)
Yeah, sure. Well, born and raised in Dallas, Texas, but been on the West Coast for a while. I’m a physician. My training is in integrative primary care, which I was practicing for a number of years before Really, I got head hunted and then joined the team at Vion. That’s right around the pandemic. I looked real smart. I kind of dodged the whole COVID fiasco that was, you know, the clinical nightmare. Happy to support the folks that were in the trenches, but

I didn’t miss a beat the first day of the pandemic, we all went from home. That was my first day at Viome. again, just pure dumb luck, but I looked real smart. But what drew me to Viome was one, the science and the technology and two, really this idea of precision medicine. How can we bring personalization forward? Many would say, hey, we’re not quite ready for prime time yet. But I felt Viome and their science were really already engaging.

⁓ in meaningful personalization. And mainly that’s through the microbiome, right, which is a huge lever for personalization. that, and then the kind of food first, nutrition first, behavioral lifestyle modifications that enabled through Viome’s assessments really spoke to me and really just the breadth and the being able to touch so many more lives and…

patients than I ever could just in clinical practice. So yeah, that’s me. Got a dog, four kids, I don’t know what else. I love to surf, I love the beach.

Steven Schwartz (02:20)
very exciting.

No, that’s great.

⁓ You had said you did some schooling in Southern California.

Grant Antoine (02:30)
That’s right. four years of med school and then did my residency in integrated primary care at UC Irvine, Sam Welley Integrative Health Institute. I feel they’re really trying to drive change in the space, really build truly an evidence base for integrative medicine, much like they’ve done through the VA and the whole health or whole body ⁓ program there. But yeah, that’s kind of my early beginnings.

Steven Schwartz (02:53)
Nice. I meant to mention to you earlier, I actually grew up in Southern California. I grew up in the town of San Pedro on the harbor of Los Angeles area and a short stint of school at UC Santa Barbara. And then I transferred up to Humboldt State University up in the Redwood trees. And that’s where I got my degree in math and computer science and then transferred over to Clemson, South Carolina for a graduate school. And I was there for maybe two weeks. It was not the right program for me.

Grant Antoine (03:01)
Right on.

Steven Schwartz (03:19)
And so I dropped out of that, moved to the Washington DC area, living in Northern Virginia and working in tech there. And after 9-11 happened, said, you know what, I don’t want to be in this town in this area anymore. I need something slower and safer. And I moved to Florida. So for me, that’s my quick story of two different coasts and tech, but it’s amazing how our lives have our path and the ways we go from here to here to here.

Grant Antoine (03:37)
Yeah.

Steven Schwartz (03:46)
based on what’s going on in our lives, our careers, and in my case, 9-11. But anyways, I’m so glad to have you on the show. Why don’t you tell me about Precision Health Pro? I understand that’s your flagship test that concierge and direct primary care practices might want to work with you and utilize.

Grant Antoine (04:07)
Yeah, absolutely. Precision Health Pro is a provider-only test. Really, it’s built on our Metatranscriptomics platform. And all that really means is

We’re measuring RNA, right? We’re doing whole genome, I guess I’ll say, yeah, whole genome RNA sequencing. Initially started with just the gut microbiome. From there we moved to ⁓ the oral microbiome actually. And then from there we moved to blood to look at human gene expression and see what’s happening in the body, what’s happening with those mitochondria, those cells, know, immune activation, inflammation, et cetera. But really the Precision Health Pro,

It’s a tool for providers and certainly concierge practices to really utilize both the microbiome and personalization to improve outcomes and drive value for their programs. There’s a lot of the specifics built into the test, but I think what’s most important for docs to realize is that no other test on the market is measuring RNA.

That’s our differentiator and it’s because RNA is so difficult and expensive to work with, traditionally. Our chief science officer was working for the US government at Los Alamos Labs, actually solved for all those issues, holds all the patents, and ⁓ we purchased exclusive licensing from the US government for the technology. Now we have the world’s largest RNA-based lab, again the fancy term metatranscriptomics, and the world’s largest metatranscriptomics database.

We use that for our consumer division to give consumer health and wellness products and personalized supplementation recommendations, personalized food recommendations. And then on the back end, we’re mining that data with our AI teams. We have the systems biology team in New York, data science, and looking to produce novel diagnostics and therapeutics for our diagnostic division. And really, the Precision Health Pro is the first product that’s available.

We also have our cancer detect, which is an oral and throat cancer test with a high sensitivity specificity for oral and throat cancer that received FDA breakthrough device approval. And we’re looking to do the follow-up studies now to get that pay-or-pay situation unlocked and get that in the hands. I’ve really changed the standard of care. Right now, standard of care is your dentist or provider is going to take a look under your tongue.

you know, do a quick swipe with their fingers, say, I don’t see anything. You’re good to go for another year. Typically, by the time you can see or feel anything, it’s stage four. And it can be really devastating, life-threatening. So we think that’s a game changer. But it gives you an idea of the science and what’s going on in the background with violence. ⁓

Steven Schwartz (06:33)
so

many interesting things that you guys are working on and I’m a huge believer in get the tests, take the tests and find out if you’re susceptible to a specific malady because you know that’s what it’s all about. So many cases and again I’m not a doctor personally but it seems like so often if you know about it early enough you can do something about it and when you know when you don’t know early enough many times it’s too late.

Grant Antoine (06:55)
That’s right.

Absolutely right. Couldn’t agree more, Steven. And that’s really our mission, early detection, early prevention. And that’s why RNA is so valuable. know, DNA, that’s the master blueprint of all possibilities, right? And that gives us some information. But it can’t tell me if you’re alive or dead. It can’t tell me if you’re sick, if you’re well, right? And so it’s, well, we can start to get at things like risk and polygenic risk scores. It’s kind of…

limited in its action ability. Now I’m not telling anyone not to go test your genetics. There’s actually, you know, there’s utility there. But when one, comes to the microbiome, and two, depersonalization, its RNA enables so much more, right? Because now we know of that blueprint, which genes are actually being expressed, right? That infers the activity. So certainly from a microbiome standpoint now, we’re not just naming the names and saying, hey, these are good microbes, those are bad microbes, this is the relative composition.

We’re looking at that actual activity and it’s the activity of those microbes. That’s what we evolved with, right? That’s the love language between the microbes and our systems, ourselves, our nervous system, our immune system, our digestive system. It’s that molecular communication that’s so important. And today, the science has really been stunted because it’s been so hyper-focused on composition. So we feel we can bring that activity forward.

We have a really straightforward report. It’s very succinct and zooms in on things like butyrate production, TMA production, inflammatory activity, gut lining health, oxalate metabolism, and more. ⁓ And the great thing is you don’t need to be a microbiome expert to decipher or to take action on any dysfunction that’s identified through the report. We both identify

the dysfunction and provide a nutritional solution, right? So we’re gonna give personalized food and supplement recommendations that target that activity to improve it so that we can improve the health of the patient. And we can do that because we know, again, through RNA, which genes are being expressed, right? So if I know the genes and the enzymes that are involved in the pathway, now I can map that pathway and I know all the substrates, I know all the cofactors that are required for the enzyme.

to upregulate or downregulate its activity. I know the substrates that are required for the reaction to occur. I know the output, right? Those molecules that are coming out of that pathway. And I can target any area, again, to modulate that activity to improve it. So if it’s a beneficial pathway, we want to promote it, right? Something like short chain fatty acids and beta-rate. They’re anti-inflammatory. They help us with our insulin sensitivity and glucose control. Great for the gut lining, right?

We want more of that. We want as much of that as we can get. And so zooming in on that activity, we can do just that and give personalized food and stuff up recommendations. So do I need to give you probiotics? Maybe not. Maybe you already have the microbes in there to do the work. They’re just not utilizing those genes and pathways to actually produce the butyrate. Now we can stimulate that, ramp up that activity, and use the specific fibers that will do just that.

Steven Schwartz (09:58)
I’m so glad you brought that up because for people such as myself who are not medical in nature, but we want to live healthy lives. We want to make sure the fuel that we’re putting in our bodies is the correct fuel to help us run at an optimal rate. And so in so many cases, you know, we buy supplements and vitamins and whatnot.

And thinking that we’re doing our body good by, well, know, vitamin C or ester C, or I need some D, I need some zinc, I need some whatever. And, you know, if we don’t first test our bodies on what we truly need, I think we’re number one, probably wasting a lot of money. ⁓ Number two, we have more expensive urine. And number three, in some cases, we’re probably doing some damage or harm to us taking more supplements than we really need.

Grant Antoine (10:35)
you

you you

Steven Schwartz (10:48)
⁓ or something that’s like, we don’t need that much, you’ve already got enough. So I’m thrilled to hear that your tests can help identify the type of supplements

that we should be taking and which ones I assume to avoid so we can have that optimal health. What are your thoughts on that?

Grant Antoine (11:06)
Yeah, absolutely. And I think a lot of providers out there share this sentiment, right? Supplements and the supplement market, it’s kind of the Wild West, and they don’t even know where to begin. And certainly, your average doc didn’t get any training on supplementation or nutrition even. And I think we really help unlock

that though, because I think supplements are still a powerful tool. Yes, everyone shouldn’t take everything, right? We need to be targeted. We need to be specific. We need to be personalized. But there is good evidence for supplementation as a powerful tool. And when it comes to those pathways, it just gives us that much more specificity when it comes to leveraging, really, just the biochemistry. And if we think of the microbiome, it’s really this

individualized metabolic organ that we all have within us, right? Your microbiome is very different from my microbiome, but it’s still providing both our bodies what our bodies need to thrive, right? But if we look at your standard diagnostic stool tests that are available on the market today and that so many practices are using, they’re hyper-focused on composition, right?

It’s because they’re DNA based. And again, they want to name those microbes and look at that composition and infer say, hey, this is, you know, maybe you don’t have a good commensal balance and what have you. So we think that’s a little short-sighted. I think the power of these tests, I don’t want to poo poo on them because they’re still a valuable tool in my mind clinically. But if I need to run parasitology or I need to rule in or rule out pathology, I’m going to look at fecal calprotectin, you know, fecal IgA.

Maybe I want to look at short chain fatty acids levels in the stool. Those are powerful insights, but it’s not for everybody. With such a low prevalence of parasite carrying individuals in the US, I think it’s less than 3%, why are we spending hundreds and hundreds of dollars on these tests when really we’re just looking to further personalize and…

individualize our treatment programs. So I don’t think we need to be running parasitology on everyone that walks in the door. Maybe if someone had some recent travel, maybe they went to Africa and came back and had acute onset GI symptoms, yeah, certainly, let’s take a look under the hood. But for your average patient walking into a concierge practice, they’re just looking to optimize, they’re looking for a functional assessment.

And I think that’s where the Precision Health Pro wins, right? Where a functional assessment really zooming in on that activity and bringing that forward for the provider. And because that activity, it’s meaningful, right? And a lot of providers, like you’re not gonna know, hey, what’s TMA? Like, why do I care about TMA? Why do care about oxalates? What are these terms? I don’t even know. Why do I care about methane gas production in the gut? But it’s, again, these activities.

influence our health. And ⁓ the Precision Health Pro brings that activity forward and tells you why it matters. ⁓ And there’s actually a feature in the report that we look at disease risks and we stratify that risk. if I look at anyone’s microbiome, I can zoom in on that activity and I can say, okay, well, I see low butyrate production. Maybe I see high methane gas or high sulfide gas production, right?

high uric acid or lactic acid production, see inflammatory activity, poor metabolic fitness. What does that all mean for me? Viome’s gonna synthesize that information and actually on the back end, we’ve done the cohort analysis to predict risk and what that activity might mean for the patient. Are they at increased risk for inflammatory bowel disease? Are they at increased risk for diabetes, obesity?

Is there increased risk for anxiety, depression, chronic fatigue syndrome? We have 20 plus conditions that we assess for in the current report. And much like polygenic risk score calculations, we apply the same methodology. So for each dysfunctional pathway we identify, that infers some increased risk, right? Because that’s dysfunction that’s contributing to that possible pathology. But we can sum up.

that activity for the individual and like, what’s their overall odds for these conditions? I mean, oftentimes we’re seeing odds ratios above 5.0, right? These are meaningful clinically relevant odds for your patients. And the good news is because this is early detection, because this is biochemistry, again, we can get at it through nutrition. So we identify that dysfunction, we can identify that risk.

But again, now we can give the personalized food and supplement recommendations to target that, lower both their risk and improve their symptomology and how they’re doing.

Steven Schwartz (15:43)
Dr. Grant, this

has been so interesting and I wish we had more time to dig into more details, but we’re truly running out of time here. If a concierge or DPC practitioner is listening to this interview and loves what you’re talking about and want to get in touch with you personally to ask you questions or to get in touch with Viome, what’s the best way to get in touch with you all?

Grant Antoine (16:04)
Personally, grant.antoine at viom.com if you want to reach out with your questions, but certainly viompro.com is our professional website. You can write you out, you can ask for more information there. Our account executives, Jim Dermen and Crystal will reach out and follow up. Really simple to get signed up, look at the test and there’s…

options there for volume pricing and discounts for your practice depending on how you’re set up. Dropship, know, in-house inventory, like all the options we can work with you. Maybe you want to have direct control over the food and supplement recommendations before those go to the patients. You have that option or you can have them immediately released to an app that the patient has so they can get started on that lifestyle modification. really, plug and play.

with a lot of options to personalize to your individual practice. So yeah, I would encourage folks to take a look.

Steven Schwartz (16:53)
I love it. Well, thank you so much for your time and being the guest on the Concierge Medical Marketing Podcast today. And I usually like to end our podcast, but just saying if you own a concierge practice or direct primary care and you need help with transitioning patients from an existing practice to a membership or to grow your practice to the full panel numbers, or even if you’re full and with a waiting list and you need help with nurturing your existing patients so they remember

and keep your practice in their mind. That’s what we offer at Concierge Medical Marketing, several different programs. If someone would like to meet with me and have a discussion with me about ⁓ marketing issues, simple way to get on my calendar is cmmkg.com forward slash schedule and pick out a time that works on your calendar and we’ll have a conversation.

Grant Antoine (17:28)
Okay. Okay.

Steven Schwartz (17:47)
It’s been my pleasure, Dr. Grant and Antoine. Thank

you for taking the time to be my guest on the podcast today. I wish you and Viome all the very best and please keep up the great work because this stuff is so exciting and you guys are truly cutting edge.

Grant Antoine (17:59)
Thanks, Stephen. Appreciate it.

Steven Schwartz (18:01)
Pleasure. Folks, have a great day and we’ll

see you on the next episode. Bye for now.