Hi and welcome to the A16Z podcast. I'm Hannah. A lot's going on in the world of health care right now, and one topic that's especially relevant is how diagnostic labs work. The conversation that follows, which was actually recorded at our A16Z Innovation Summit in November, covers everything from the evolution of the modern lab over the past 50 years, especially as new technologies and new tests are added, how tests go from being specialized to mainstream and widely available to who pays how and how reimbursement works.

We also discuss where information from the lab flows in electronic health records or elsewhere in the health care system,

a topic we've covered before on this podcast, so be sure to check out those past episodes

with general partner Julie Yu, and touch on what the lab of the future might be like.

Joining this conversation with me and general partner Jorge Condé is Dave King, executive chairman

and previous CEO and president at LabCore, one of the

largest clinical laboratory networks in the world.

So where should we begin when we talk about the evolution of the modern lab?

What's the history and what do you think of as the timeline of where we began to what brought

us to the modern lab today?

Our original founder, Dr. Jim Powell, was talking about why he came up with the idea of a reference

lab and he's a pathologist and one of the things he pointed out is that in the day in

1969 when a test was sent to a laboratory, sometimes it would be five, six days before

a response came back and the patient either had progressed or as he said, you know, progressed, released or died.

Too slow.

Too slow, not super reliable or reproducible in terms of, you know, overall quality.

A lot of work was done in hospitals or small laboratories.

Jim's idea was, let's put the instruments in one place and bring the specimens instead of sending the specimens somewhere and waiting for the answer to come back.

And obviously that's evolved over the course of time into reference laboratories that look like warehouses.

I mean, they look at manufacturing facilities. You know, large numbers of very high throughput instruments, very IT and tech connected.

We have a robotic sorting machine that we're putting into all of our laboratories,

which basically replaces all of what we used to do with the front end manually,

...