I was dubious when Crystal Icenhour approached me to write about her medical testing company.
It sounded too much like Theranos, the discredited start-up that claimed to have medical technology that revolutionized blood testing by using minuscule samples.
Theranos ceased operations last year, and its founder, Elizabeth Holmes, the self-made billionaire and “next Steve Jobs,” faces federal fraud charges. Forbes magazine reduced its estimate of her net worth from $4.5 billion to zero.
Icenhour is no billionaire, but the gritty Texan — she cleaned floors in her family’s truck-repair shop — is an entrepreneur with a doctorate in molecular medicine from the University of Cincinnati Medical School.
She said the Theranos story dogs her on fundraising and rounds promoting the business to potential clients such as health insurers and hospitals.
Her firm is impenetrably named Aperiomics. Aperio is Latin for “reveal.” (“Branding is not my forte,” she said.)
“It’s really frustrating,” the 45-year-old medical research scientist said. “Theranos has done a huge disservice.”
For one thing, Icenhour never, ever wears a black turtleneck. Black turtlenecks were Holmes’s signature look, channeling Silicon Valley icon Steve Jobs.
“Anything we can do to differentiate ourselves, we do it,” Icenhour said. “I am careful how I make our pitch. We stopped using words like ‘single test.’ ”
She also touts her credentials, including a PhD and fellowships at Duke Medical Center and the Mayo Clinic. (Holmes was a Stanford dropout.) She emphasizes that Aperiomics received a grant from the National Science Foundation.
Ashburn, Va.-based Aperiomics is a precision medical biotechnology company that crunches data to help people with chronic illnesses find the cause and fix it.
Depending on what type of symptoms the patient has, Aperiomics takes a clinical sample from a patient’s blood, tissue, feces, swab or other sources and sends it out to a laboratory partner, who sends back a raw data file.
Aperiomics’ secret sauce is its proprietary analytics and database.
“We crunch the data and determine what is in the sample,” Icenhour said. “We are taking capability already existing in some labs and using the software to dig into the information and get more comprehensive answers.”
About 350 doctors have ordered the testing on behalf of more than 1,000 patients from 18 countries
Most of its patients have been sick for a very long time, sometimes decades, and find Aperiomics through Google, Facebook or through the company website or word of mouth.
Aperiomics requires a patient’s doctor to sign off on the testing.
“Most of the time, the patients take us to their doctor and say, ‘I want this.’ Our patients are well educated and chronically sick, and so they refused to accept their condition,” Icenhour said. The company will provide support to help the physicians understand the test results.
A lot of the analysis deals with boring but painful issues such as chronic bladder problems. They find some pretty gross stuff, too. They identified human whipworm in a young man who had been sick for six years. Another man had a rare infection that came from his cat’s fleas. They found leprosy in a Northern Virginia resident who had traveled to Haiti.
It’s a tiny company with six employees and $1 million in revenue for 2018, but Aperiomics has yet to turn a profit. The company owns its own computers but relies on Amazon Web Services for cloud capabilities. (Amazon Chairman Jeffrey P. Bezos owns The Washington Post.) Icenhour has raised over $1 million from investors and owns 15 percent of the firm.
Icenhour said millions of people suffer from chronic infections that are undiagnosed or misdiagnosed. Aperiomics tries to complete the picture.
Sometimes the picture is humorous.
She remembers driving in her car when one patient phoned her with the following greeting to describe his ailment:
“ ‘Uuuuuuhh, so . . . I slept with a prostitute,’” Icenhour recalls, adding, “there’s never a dull moment.”
Like most of the health-care industry, the payment system is complicated. Patients not using insurance pay a discounted average cash price of $1,000 for a test. The average insurance payment from private payers is about $3,000 per sample.
The company has relationships with UnitedHealth, Blue Cross and Cigna for patients out of their networks. Patients with those companies can pay from $200 to $700 out of pocket.
Icenhour became interested in medical mysteries while growing up in Texas and Oklahoma. She spent a lot of time with her chronically ill grandmother, visiting doctors as they tried to find the source of her pain.
“I wanted to go into a field where I could help,” she said.
She was the first in her family to attend college, graduating from the University of Tulsa in 1995.
Icenhour wanted to be a physician but detoured into graduate school after she realized she was better at research.
“I am good at putting puzzles together,” she said. “That’s the common thread throughout the work I have done . . . connecting dots.”
She also had the entrepreneurial gene, having grown up in a family-run business. Her parents ran a large-truck repair shop in Fort Smith, Ark., near the Oklahoma border.
Fetching wrenches, mopping grease from floors, stocking parts and keeping the books taught her that owning a business includes an unglamorous, scrappy side.
“I did whatever it took to make the business run,” Icenhour said.
After college, graduate school and fellowships, a colleague recommended her to a friend at the University of Virginia who wanted to found a biotech company. They named it Phthisis (the co-founder picked the name), which is ancient Greek for tuberculosis.
Icenhour moved her whole family, which includes four children, to Charlottesville.
Phthisis made kits for clinical lab testing. It ended up being acquired in a “graceful exit,” in which everyone got their money back, investors included, but no one got rich.
A Virginia business acquaintance put her in touch with three academics — two professors from George Washington University and another from Boston University — who had created academic software that could identify microorganisms.
“They are computational biologists and statisticians,” Icenhour said. “Math guys.”
Icenhour’s contribution was to find how the bioinformatics, as it is known, could be put to practical use in health care.
She joined the company March 1, 2014, and has been going nonstop ever since. Aperiomics hit $250,000 in revenue in 2017 and then hit just over $1 million last year. The company breaks even, but Icenhour hopes to turn positive in the next couple of years.
I caught her on her cellphone as she drove her Rav4 back from a fundraising pitch in Pittsburgh. At the time, she had $675,000 of the $2 million she hopes to raise in her latest round. Now that’s up to $995,000.
That tells me she knows what it takes to make the business run.