Season 2, Ep. 13 | Season 2, Ep. 13 | Transforming Women’s Health with Rosalind DX Transcript

​More Elephant Intro

​[00:00:38] Jason Rudman: Rosalind DX is a company revolutionizing prenatal care by making genetic testing faster, affordable, and more accessible. The company's goal is to make prenatal testing accessible for all women regardless of socioeconomic background. The solution is a breakthrough approach that brings prenatal testing to polymerase chain reaction or PCR, enabling five times faster turnaround of population level access.

This is a significant step forward in the field of prenatal diagnostics, addressing the historical underfunding and gaps in oversight in women's health, and providing an alternative to traditional prenatal tests like amniocentesis, that can be invasive and risky.

It is a great honor from across the globe to welcome the co-founders of Rosalind Dx, Dr. Ella Fung, who joins us from Singapore, and Dr. Nancy Schoenbrunner in the United States.

Welcome to the latest More Elephant podcast.

​[00:01:35] Ella Fung: Thank you for having us.

​[00:01:37] Jason Rudman: I'm thrilled. It's great to meet both of you. I know that we're going to learn a lot from both of you in terms of this fantastic, almost revolutionary approach that I mentioned at the outset.

And, we always like to start with everybody's origin story of what got you to this point. So, in an order that you choose, we'd love to hear a little bit of the background and then we'll get into how the two of you met and how you formed Rosalind Dx.

​[00:02:06] Ella Fung: Thank you. Jason. I'm a scientist by training. I've always been really interested in learning and understanding how things work so I did a PhD in oncology.

Cancer is a disease that really fascinated me from a genetic perspective—understanding what makes a cancer sensitive or resistant to therapy. After I finished my PhD, I went to work in industry; my first role was at Pfizer in drug development, and at that time I was working in obesity. It was really cool seeing the behind the scenes of how therapies are designed and developed and then commercialized.. After my role at Pfizer, I was curious about the startup space. At that time, I was in Boston. You can't miss the startup ecosystem there, and that was how I got connected with Nancy [Schoenbrunner]

So at the time Nancy had the [00:03:00] concept of this prenatal testing technology. I had also had our first kid so it was very near and dear to my heart. We had just experienced that whole patient journey about what the test was, how stressful it can be, and how inaccessible it can be to some families. So, getting to work on something that was very meaningful, that I could also apply my technical skills too, was a no-brainer. And it's been great to work with Nancy ever since.

[00:03:32] Jason Rudman: I'm  going to go all the way back. How did Ella Fung get interested in science? And you can't just jump to a PhD. It's not that easy, right?

So if you would, where did you grow up? What was growing up like? How did you find your way to science?

[00:03:42] Ella Fung: Oh, I'm originally from Hong Kong, but I spent a number of years in Canada growing up. I was always interested in understanding why things happened. So that was the interest in science.

I also grew up watching Magic School Bus, which I'm now exposing to my toddlers, and they love it too and the way that I found my way to science was because of that, wanting to understand why things happened. 

The other, I vividly remember that before university, I was picking because you have to pick which subject area you're interested in. The other area I was interested in was economics because that was also understanding why different things happened and describing our world.

In the end, I chose science because to me that was the only subject where you were studying something that was not man-made. You were just studying what exists in nature, how things are, what they are. In economics, it's other companies or other economies or other countries, but those are all man-made. So, that was the difference that helped me choose science and I'm so glad I didn't pick economics in the end.

It's also been really fun now on the startup journey that a little bit of that business side is coming back up and that I'm able to have fun learning the business aspects as well.

[00:05:10] Jason Rudman: Yeah, one of your first More Elephant moments when you realized that science was your path and not economics. Did you study both at university?

[00:05:19] Ella Fung: No..., 

[00:05:19] Jason Rudman: Where did you go to university and the science not economics moment? When did that arrive?

[00:05:26] Ella Fung: That arrived in high school. I remember because we were applying to university. I ended up going to the University of Cambridge, and for UK universities, you have to decide which subject you're applying for. So that was what pushed the decision earlier.

I did also apply to some US universities where you can keep it open, but in the end, when the offer came for Cambridge and in natural science, which is one of their strongest subjects, I was happy to make that decision then.

[00:05:57] Jason Rudman: I just love how you gently dropped in that you went to the University of Cambridge in the U.K.; from a fellow Brit that's not easy, and you're going to one of the best institutions in the world to go learn your craft. So, I appreciate that you slid that one in there, under the radar. Where did you study your PhD?

[00:06:14] Ella Fung: The University of Oxford.

[00:06:16] Jason Rudman: And for those of you listening, you went from Cambridge to Oxford. It's like an episode of University Challenge on this podcast right now.

[00:06:22] Ella Fung: I defected Jason.

[00:06:24] Jason Rudman: Yeah, there you go. And that pause was because we got a right smile out of Dr. Fong when she actually said, I went to Oxford.

Nancy, I know you've got an equally impressive story grounded in education, grounded in science. So, how does the journey manifest itself? Early years, what were you interested in? How did that show up in terms of the choices that you made from an education perspective?

[00:06:49] Nancy: Yeah, sure. So, I became interested in science probably in late junior high school. I came from a family with no scientists in it for sure. So I had no role models. I loved reading mysteries as a child. Just loved mysteries. And as I started studying science in school, I realized it was like a mystery, trying to understand how things worked, why they were the way they were. So for me, there was a natural connection there and then, in [00:08:00] high school, I was all about science. It was a no-brainer for me.

Got wonderful opportunities to do summer internships, even during high school, so working in labs absolutely fell in love with it. I ended up doing my undergraduate in the U.S., did a year in Edinburgh, Scotland, got a scholarship to go to Germany to do advanced studies and then ended up moving to Switzerland for my Ph.D.

So yeah, I started and never looked back. I was just tweaking the exact subject matter. I ended up studying something called protein folding, physical biochemistry—just loved it. I landed a job in industry right away with a large company called Roche and it was a true honor to work with the inventors of PCR.

PCR is the technology that we're using at Rosalind DX and [00:09:00] worked at Roche, which is a very large company with over a hundred thousand employees worldwide for almost twenty years, before taking the leap into the crazy world of start-ups in 2018. 

[00:08:33] Jason Rudman: The crazy world of startups. We will get to that crazy world in a minute. What I love is about this podcast is an opportunity to just sit back, listen, and learn from great people doing great things. Nancy, you mentioned protein folding and that was a light bulb moment for you. I really enjoyed that. And then, Rosalind DX is grounded in PCR. Could we take a moment to explain protein folding and what actually got you so excited about that? And then PCR because it's so core to what you're doing at Rosalind DX?

[00:09:07] Nancy: Yeah, sure. So protein folding is understanding how proteins, which is one of the core biomolecules of life, how it achieves its structure because it's very complex, it's this long chain of pearls, but it assumes a very specific three dimensional structure. That structure is a bit dynamic.

So understanding how that process happens, predicting it, it was just such a wonderful subject to study. And that's what got me my job to do lead enzyme engineering at Roche, specifically Roche Molecular Diagnostics. And I was with the group that invented PCR; a fascinating group of people to work with in a fascinating time.

PCR is what allows us to amplify DNA, whether it's to detect a specific sequence that may be linked to a disease for diagnostics or to clone genes. It's just the core of all the molecular biology [00:11:00] revolution.

[00:10:12] Jason Rudman: That's excellent. And, as you described the protein folding, you described your connection to mystery because it's a perfect metaphor for the mystery books that really intrigued you.

Ella, what's your connection to PCR and is there protein folding in your history as well or another mystery that intrigued you and unraveled over time?

[00:10:33] Ella Fung: A little bit. For me, I always approach science from the molecular biology perspective, which protein folding is one aspect, but I approached it more from a problem solving angle. Not specifically just one technique or the other, but what really piqued my interest was whenever there was an interesting project and that might be, Hey, there's this protein that's like a pacman and it's supposed to eat something or something is supposed to fit in the whole of this enzyme, but we don't know what it is.

That's like a mystery and approaching those subjects, you have no idea what the substrate for the enzyme might be, so you just use all the tools at your disposal to try and figure it out. That might be a little bit of protein folding or it might involve some cloning and PCR.

I remember during my Ph.D we likened my project to a fishing expedition where you don't know what you're going to get, but you cast the line over and you try in different ways until you figure out what exactly it is. So that was how I came to fill my molecular biology toolbox with all these different methods that could help solve interesting problems.

When I met Nancy and she already had the idea for this problem to solve and the solution, that was a matter of the skills fitting the problem really well.

Also, because I was personally interested in that space. Sometimes you get put on a project, especially if you're a more junior scientist, where the project is picked for you. You might end up working on a topic that doesn't really interest you personally. But in this case, I was very invested and really wanted to make it work, and also had the skills to do so. 

[00:12:23] Jason Rudman: And Ella, you had mentioned that this was after the birth of your first child that you and Nancy came together. We should acknowledge that amniocentesis deaths—it's about one in two hundred to one in four hundred. One could argue relatively rare, but too many in terms of the impact that it has.

Was there a particular experience with the birth of your first child that made this even more personal?

How did that play into, if at all, this meeting of the minds with Nancy and forming of a company?

[00:12:56] Ella Fung: Thankfully everything was okay with our journey, but it really, it's one of those experiences that until you are going through becoming an expectant parent, I know you're also a parent, Jason, that you don't fully understand what that patient journey is like.

You could read about it on paper, but then really going through it, and understanding the stressful decision points for us. With our first kid, we actually were fully insured and we were covered; this test was covered when we were offered the test. We didn't think twice because it was presented to us alongside all of the other blood tests that we had to do. So we thought, yeah, of course.

And we were encouraged to take it as well. So of course, we followed what our doctor recommended, got our results. Thankfully everything was all clear, low risk. And then, when I met Nancy, what really stuck out was that it's not an equitable process at the moment.

The patient journey forks in the road. If you are not covered, if you can't afford this prenatal testing, the non-invasive method, you are first left with ultrasound, which is ten times less accurate, which means that you're more likely to end up having to do amniocentesis or other invasive methods.

So, imagining that when we were in that journey, if we hadn't had the insurance coverage or, in our second pregnancy, we actually didn't end up choosing the test because we didn't have insurance coverage and it was out of reach, we also experienced the flip side of access. 

It was the fact that it wasn't equal and that parents' means would directly affect how accurate their results were because of the level of technology [00:16:00] that they could access. That was inherently wrong in my view, and that's why it is such a compelling problem to work on. 

[00:14:51] Jason Rudman: Agreed. You mentioned the parent of two kids and we have both kids through surrogacy and I do remember week twenty/twenty one, there or thereabouts, talking with the doctor about the risk factor.

I think ours was more amplified because I would argue that, like you described, we actually had access to healthcare. Not really appreciating the procedure and the benefits of what the procedure can reveal or not reveal, you're managing through that and the whole conversation is invasive. There's risk, and surrogacy takes your pregnancy to the next level from our perspective. I just remember the palpable sense of dread actually when we were confronted [00:17:00] with that decision. And we ultimately went forward with it, but it was a huge period of unease for us.

[00:15:41] Ella Fung: Yeah, this really reminds me of how, I haven't thought of it for a while, but when you are expecting, and then, even in parenting, you really feel the weight of every single decision and you're always terrified that you're going to make the wrong one, especially for whoever is pregnant or making the key decisions.

You're wondering, am I eating the right thing? Am I seeing the right doctor? Am I choosing the right tests? And it never ends. Then they're born and then you worry am I sending them to the right school? 

[00:16:08] Jason Rudman: It never ends because it's a different set of decisions. Just as an aside though, the diet of our surrogate, our surrogate was in rural Oregon. Wonderful, wonderful person. They eat elk and bear and we don't eat elk and bear. And I remember looking up at the FDA and saying how much elk and bear should a pregnant woman actually eat, and is it safe? So I get all of that. To your point, it actually never stops once the beautiful [00:18:00] gift is born. It's just another set of decisions. 

Nancy, similar question. The personal connection to what you're working on and how have you reflected on that as you've built this company?

[00:16:46] Nancy: So, my children are grown adults, so it wasn't the experience and when I was pregnant in Germany, the test wasn't offered. I don't know if it was because of risk factor because I was young or they just don't do it. 

For me, the connection was I really love using the skills from all of my training and professional experience to move the needle forward in terms of making, using technology to improve healthcare access quality, reduce risk, whether it's detecting diseases earlier, doing it safer.

This was a project that actually, it started because I worked on this as a sort of a paper exercise, a little bit of a actual lab project and I was still at Roche. 

We recognized that something was happening when these next generation, non-invasive prenatal tests were coming out [and] looked into the possibility of doing it by PCR, to understand the technical hurdles in this field.

There's certain IP hurdles—intellectual property, patents—but the importance of the access and reducing that risk of amniocentesis. So we knew this was going to be adopted quickly, and it has been over the last four to five years. But, it still remains very expensive and complex for labs to run this test because they're basically sequencing the whole genome from the mother's blood. And, it's silly to sequence the whole genome just to count a couple chromosomes and see if there's an imbalance.

My husband also worked in this field and he was the one that came up with the original idea, came in a dream and then he drew a structure on the whiteboard in the morning and I said, oh, that's interesting. That solves the problem that I knew about. So yeah, that's how it started.

[00:18:42] Jason Rudman: Okay. We can't let that one go. So it came to your husband in a dream and then you had a whiteboard session. You had a design thinking exercise and you said you've just manifested what I think we should solve for. A little bit of color on your husband's dream and maybe connected to how you and Ella then found each other.

[00:19:02] Nancy: Yeah, so that happened right before the pandemic and then he just drew the structure on the board and explained it, and I was like, ah, that solves the problem. And so, when the pandemic started, we both had the opportunity and time to work out the idea. That's just how we spent the early days of the pandemic.

We worked out this idea very intensely, filed some patents and then a couple months later I decided, you know what? I should just go in the lab and try this out.

And so, that's when we said we want another scientist to help us and somebody in that lab incubator knew somebody who knew Ella. That's how we connected.

[00:19:48] Jason Rudman: Awesome. So you ultimately decide together, you're on these separate trains, there's this entrepreneurial spirit that's eating away and it has to eat away you to make the leap from scientists to entrepreneurialship…

[00:20:04] Ella Fung: Hmm. 

[00:20:05] Jason Rudman: The company, I know names and honors Rosalyn Franklin, who's a pioneering female scientist.

We'd love to hear a little bit about her story how did the two of you take this idea of honoring Rosalyn Franklin and start the company? 

[00:20:21] Ella Fung: Rosalyn Franklin she's a female scientist who made one of the most major discoveries in modern science, the structure of DNA. She's also an alumna of the University of Cambridge and was at the women's college where I attended, and she was one of the first to attend the University of Cambridge.

She was working on a special way to take photographs of molecules called x-ray crystallography. At the same time, there were many other scientists trying to figure out the structure of this molecule called DNA, in particular, Watson and Crick, who were also at Cambridge. 

She took the famous photograph 51, which depicts this X helix shape, which was the unlock that helped all the other pieces of the puzzle fall into place, especially for Watson and Crick. The circumstances of how her data ended up with Watson and Crick, and then how they realized what it meant and built it into their model but didn't credit her, is more of a complex story, I believe. 

But ultimately, Watson and Creek were credited with the discovery, Rosalyn Franklin was not. She passed away young because of cancer. She spent a lot of time around x-rays, and when the Nobel Prize was awarded, they don't award it posthumously. So, she wasn't awarded it. She wasn't credited for that discovery.

I remember when I attended university, there was a plaque in the Eagle Pub, where Watson and Crick came in and said, we've discovered the Code of Life or the Secret Code of Life. In recent years, they took that plaque down and put a new one that also has Rosalyn Franklin's name on it. So when we were thinking of how to name our company, we knew that it was going to have a strong women's health element. Nancy and I are both female scientists, and we had some nerdy names on the list as well that I don't even remember anymore, but Rosalyn DX is the one that stood out.  It just has so many little Easter eggs for ourselves and it's more personable, so it really stands for a lot of things that we do as well.

[00:22:34] Nancy: And, can I point out Jason, that Ella and Rosalyn Franklin also share a birthday?

[00:22:41] Jason Rudman: Oh, that little Easter egg. The University of Cambridge and Ella and Rosalyn share a birthday. And then honoring as two,m female scientists turned entrepreneurs, an unsung female scientist. We've seen that happen many times in history, right? This would not be the first time that somebody brilliant does not get their due credit. So just a remarkable story and again, honoring greatness in the way that you are.

So you find each other via Tinder in a lab; somebody said, swipe left a couple of times and you're gonna find Ella. Okay, so you've got the idea, Nancy, the dream state to the pandemic ideation in the lab. You need a third scientist, you find Ella, but then you actually have to incorporate a company. Take us through that journey.

[00:23:34] Nancy: Yeah, we started with a small LLC [limited liability company] in the U.S. that holds the patent, the IP and worked on the side, as a side project, for the very early proof of concept.

Ella moved back to Singapore for family reasons. Got a job. Unfortunately lost that job when she was seven months pregnant. We had kept in touch. She was helping us on the side with a little consulting, and then we had this idea, why don't we start a company in Singapore because Ella is great and the Singapore government is very supportive of innovation with grants and funding.

So yeah, the rest, Ella could talk about starting the company and being willing to step in as CEO.

[00:24:23] Jason Rudman: So, Ella Yeah let's talk about that. And the unfortunate, potentially fortunate, losing of a job. I can't imagine what that was like being seven months pregnant…

Would you have contemplated taking the leap if you had the security of the job? And then first time CEO. What goes through one's mind about saying, Hey, I'm going to step into this space and be the CEO of this remarkable technology and try to grow this company?

[00:24:53] Ella Fung: This was a very fraught time for decision making. So, yes, seven months pregnant. Unfortunately, that full-time job, that company went bankrupt in the end. So I was in one of the retrenchment exercises. Of course, looking back, it was one of the, in a way, best things that could have happened at that time.

You're right, that I think if it hadn't happened, especially with a baby on the way, I wouldn't have made that leap at the time, but the decision was made for me that I needed to job, hunt, and I remember vividly being on Zoom at the time because job hunting and interviewing, most of it, especially the first round interviews, even the second, it was still done remotely.

I remember interviewing when I was seven, eight, and then nine months pregnant, and no one could tell because they couldn't see. It was only when they would ask me about timing and I had to tell them that I was expecting so I could start at x date that you could see the switch. So, it was not an easy time to job hunt.

There were offers but I had been working with Nancy and my favorite team on this favorite project of mine on the side and everything paled in comparison. It was really hard to pick an offer because none of them were as good as the team I had been working with Nancy and the others and on this technology.

And for me, I got really picky about what problem it was I was working on and none of the other problems seemed as compelling. I think if any other scientists are listening, I remember being a young scientist and earlier in my career and feeling like I needed to pick which disease I was working on because often you specialize—I work in diabetes or I work in cancer, I work in rare disease—because these are the departments that form in different companies. But I could never really pick.

They all sounded interesting and I was more interested in how interesting was that particular project in whatever disease area. So, job hunting wasn't as interesting as the side project I was already working on.

To answer your question about deciding to be CEO, it happened as many small decisions, many small steps.

The first decision was that instead of finding a full-time job in Singapore, a conventional job, I ended up working back with Nancy. And a fun aside on that story was that Nancy came and said “my husband Ralph has just gotten a bonus. Let me do some maths. I think that we could use his bonus to rent you some lab space and hire you back for this prenatal testing project and at least tied you over for a few months for your maternity leave while you're still looking, perhaps. Let's just see how it goes.”

And then, three months became four months became five, became six, and we were just making more progress and having so much fun working together that at the end of six months we thought, we've used up Ralph's bonus and more, so if we want to continue working on this, we need to raise proper capital. We need to incorporate the company in Singapore where I was based full-time and I would start fundraising and applying for grants, and that's how Rosalyn DX came to be a Singapore entity.

Singapore was also a new startup ecosystem for us, so we were figuring out who else was in this space that could help us, what the different avenues were of government support, peer support, the different communities, and that was when we were incorporating. That was also the time that Nancy asked me if I would step up to become CEO.

And after freaking out for two weeks, then the decision was clear that if I didn't do it, then this opportunity just wouldn't happen, because there was no one else to do it. So, of course I said yes.

[00:29:13] Jason Rudman: Belief in a little bit of anxiety goes in that goes a long way.

[00:29:17] Ella Fung: There’s a little bit more than a little bit yet.

[00:29:19] Jason Rudman: On the podcast we've talked to a number of female entrepreneurs, and I think you bring a unique perspective. You're incorporated in Singapore; what is the appetite to fund female-led companies? Is there bias in the venture community in Singapore, has that been a challenge or has it been actually an opportunity because of the way Singapore approaches venture?

[00:29:43] Ella Fung: I think that it's been surprisingly positive because entering the startup space, female founders, I had heard about how I think a single digit percentage of investors are female, and also a single digit percentage of investment monies go to female founders. 

But something about the Singapore investment community, maybe because it has really taken off in more recent years, where this bias is more understood and people are more intentionally overcoming those biases. I think it hasn't been that noticeably different or discriminating in any way. It's also been quite positive because this rise in the Singapore venture community has coincided with the increased awareness for women's health and how important of an area that is.

It's always been assumed this small niche market, but actually fifty one percent of the population are women. It’s the majority sector of health in some ways, a lot of problems to look at, a lot of opportunities as well. 

There are a lot of investors who are actively looking into women's health, and there are always going to be challenges to start a company, to take this journey, but there are so many supportive women and men allies that believe in women's health and have come around us to help us out and support us because they really believe in the mission.

That's been one of the most encouraging parts of this journey.

[00:31:23] Jason Rudman: That's awesome. So Nancy, you decide to form a company. Can you explain then at its core the technology and the solution and what you have attempted to do in order to amplify the non-invasive approach that you have throughout the world? 

[00:31:46] Nancy: Yeah, so we're still in the pre-commercial phase, proving out the technology and optimizing it. 

How it works is it detects the DNA that is in the mother's bloodstream which is a mixture of her own DNA and the DNA of the fetus she's carrying. Some of that DNA comes through the placenta, into the mother's bloodstream, and with very sensitive technologies, you can actually count DNA derived from different chromosomes because the genetic abnormalities that we're detecting are chromosomal aneuploidies, meaning you don't have two copies, but in some cases three copies of a chromosome.

So, we extract that DNA, and then we use—we can't get too technical, it's still proprietary—but we use different enzymes to convert the original cell-free DNA, as it's called into we'll call them reporter sequences, and then those reporter sequences for us, we amplify the numbers so that there's enough to count accurately and precisely.

We're analyzing those reporter sequences on something called Digital PCR really does true counting and can do it very precisely and accurately; we use digital PCR rather than sequencing the whole genome. and because we're doing it by PCR, rather than sequencing, it takes a couple hours instead of several days. There's less to do in the lab, let's just say. 

It'll bring the cost of running this procedure in a lab down very significantly by several orders. And that will allow access.

We will start commercializing in the U.S. because the market is well understood. Many labs will be excited to be able to offer this test to their patients, to the doctors that they serve and the insurance companies will be very happy at a lower price. 

As we really ramp up the numbers and the scale, that'll bring the cost down even further so then it's even more accessible in developing countries emerging economies.

[00:33:58] Jason Rudman: And I'm assuming the mother will not have to contemplate on some level. Ella, yours and my conversation about amniocentesis the more traditional way.

Nancy, how is it different then for the mother? You mentioned DNA extraction, the moment I hear extraction, I'm thinking, something's gotta go in and something's gotta be pulled out. How is that non-invasive? 

[00:34:20] Nancy: Sure. So our test would use just a tube of blood, a pretty standard tube of blood, rather than amniocentesis. Drawing blood is minimally invasive whereas an amniocentesis, putting this long needle in through the pregnant woman's belly to draw out the amniotic fluid, that's scary. It really does have the consequences of up to half a percent of a spontaneous abortion whereas just drawing a tube of blood, I don't mind, some people really mind, but it's pretty non-invasive. The extraction is what happens in the lab when you pull the DNA out of the blood.

[00:35:01] Jason Rudman: You mentioned pre-commercialization in the U.S.

What makes the U.S. the place to start—is it simply because of the health system? One could argue the U.K. has a robust if largely government funded health system—what is it about the US that makes it the place to start?

[00:35:20] Nancy: Yeah, we could look at both and we have an investor who really wants us to look into commercializing in the U.K. sooner rather than later.

From the investor perspective, what's attractive about the U.S. is that the prices are high, it's established, the reimbursement is high. So we can start there.

And initially, the labs running the test, we'll be able to benefit [00:39:00] mostly from the lower cost of our procedure, our test and then, over time, we can bring the price down in the U.S. and as we scale up the volume, go to Europe and then from Europe go to other emerging economies. 

[00:35:59] Ella Fung: Yeah. Another strong reason I would say is Nancy, the team, the fact that we have this familiarity with the commercialization in the U.S.

A lot of healthcare companies want to go to the U.S. but don't have that key person on their team with that experience. We do, so we're able to pick the U.S. as our first market with this advantage too.

[00:36:21] Jason Rudman: Is there something you're solving for differently in less developed [00:40:00] countries that would be part of how you think about the power of the solution? I'm thinking Sub-Saharan Africa, parts of Asia that are much lower from a GDP perspective. 

Is there an angle or a sentiment there that is ultimately in the future of what Rosalind DX aims to solve for? 

[00:36:45] Ella Fung: Absolutely. That shift from sequencing to PCR is at its heart all about decentralization and increasing access.

I think we were chatting previously and one of the things that came up was even if you're in Australia right now, you take prenatal testing, chances are that your blood will be flown to the U.S. to get this test run.  It's very centralized and not accessible to LMIC's—lower middle income countries—that don't have that ability.

Being able to run this test on PCR is definitely a step in that direction. PCR was prevalent because of COVID PCR testing, this is run on a little bit more of an advanced platform digital PCR so still will require a little bit of centralization, but more regionally not shipping to one country the majority of the time. 

It will be a lot easier for countries to run it themselves, for hospitals to run it themselves, especially if there are countries with high birth rates and they have the high volumes. This makes a lot of sense. 

[00:37:55] Jason Rudman: I think you were looking for the word nonsensical. That's going to be my word because I think the fact is the vast majority of these tests in the world get shipped to the United States for testing, which…

[00:38:09] Ella Fung: Yeah.

[00:38:10] Jason Rudman: ..is mind blowing. Does that impact also the efficacy of the results? If you're shipping from.. 

[00:38:16] Ella Fung: stable.

[00:38:17] Jason Rudman: Okay. Very stable. Challenging thing is that adds a whole ton of expense into the model. 

During pre-commercialization, what can you share about the next three to six months for the company? What you're focused on, what you're aiming to achieve?

Are you still in venture capital mode in terms of looking for investors? 

[00:38:37] Ella Fung: Yeah, they're very exciting. We are fundraising at the moment. We've gotten our first offers for this raise, and in the coming, let's say six months, it's going to be all about growing the company to hit our next big milestones, which is showing that we can reproducibly detect these diseases, trisomy, these extra chromosomes in some industry [00:43:00] standard controls, what companies need to validate their tests on. And then, we'll also be getting ready to test on a small number of clinical samples as well. 

[00:39:09] Jason Rudman: Excellent. What's the critical component here as you expand? Or maybe there's a few—what's the role of the doctor? the hospital?

At the end of the day, who's the customer beyond the pregnant woman and her family? Who do you have to convince or influence here as you grow and expand?

[00:39:28] Ella Fung: That's a great question. So our direct customer is the diagnostic lab. So we would sell B2B our kit to the lab. The lab then sells the test to the doctor and the doctor sells the test to the patient.

This is a high risk test that's always ordered by physicians because genetic counseling is involved. You can't get this like the ‘twenty three and me’, the cheek swab, DNA test, the hereditary test, not quite the same.

And that means that there are key decision makers that we want to work with throughout. Not only the labs, and making sure that what we sell is something that is appealing for them to switch or to bring on board, but also for the physician that what we're testing for is what they want and that the faster result is meaningful for them, which it is.

And then, also for the patient, of course, everyone is bearing the patient in mind or they should, because they're the ones who are taking the test. This is to benefit them; to improve their journey during their pregnancy and to improve their outcomes.

So, we're working with all these different partners throughout even from an early stage because the worst case scenario is that a young healthcare company will start making something that they believe doctors and patients want, and then years later they discover that they don't.

[00:40:50] Nancy: We'll also be building out our scientific advisory board that will include the doctors that would be ordering the test, making sure that they are fully confident in our results. 

[00:41:02] Jason Rudman: I speak for everybody that's listening here where I feel like we're going to watch your trajectory and you're gonna soar over the next three to six, to nine to twelve months.

It's such an important part of women's health. Ella and Nancy, as you talked about it, that for fifty one percent of the population, on some level, it is mind blowing that we're having to have this conversation and talk about this at the beginning of twenty twenty six.

How do we find out more about each one of you and what Rosalind Dx is all about?

[00:41:42] Ella Fung: You can follow our journey on LinkedIn. That's where we post most of our news, and Nancy and I are also on LinkedIn where we [00:46:00] post our updates about how things are going, the different partnerships, the different conferences and talks that we're going to. That's the best way to keep in touch.

[00:41:57] Nancy: Exactly.

[00:41:58] Jason Rudman: And my final comment, is there any public advocacy here that's important in this space? So as you're building out the science, I can't help but think from an advocacy perspective, is there an opportunity not only for people to be informed, but also to get involved?

[00:42:17] Nancy: I think that the most important for us it's a professional association called ACOG Association 

[00:42:24] Ella Fung: American College

[00:42:26] Nancy: of Obstetricians and Gynecologists. So we'll be going to those conferences once the technology is more proven out and validated to bring them on board that they recommend. Yes, this is a test you can trust.

[00:42:39] Jason Rudman: On some level, I think, the end user, the woman that's pregnant, right? In informing her of options…

[00:42:47] Nancy: Yeah.

[00:42:47] Jason Rudman: another form of advocacy over time that is allowing the woman to own her own choices. I think ultimately that's what I take out of that part around advocating for yourself, advocating for what happens to your body and what happens to your baby. It's remarkable. 

Thank you so much for the time. I'm in awe of just listening to how brilliance and a couple of degrees of separation brought two brilliant minds together, along Nancy with your husband, who dreamt an amazing outcome that went from a whiteboard and is now on the cusp of impacting women's health first here in the United States, and then globally.

So thank you for taking the time and sharing your [00:48:00] story. We appreciate it.

[00:43:33] Nancy: Thank you so much for the opportunity. It's really wonderful to share a story.

[00:43:37] Ella Fung: Really appreciate it Jason. Great questions too.

[00:43:40] Jason Rudman: Thank you. 

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