How Health Systems Are Reshaping Clinical Decision-Making by Turning Molecular Data into Actionable Care

Summary

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Becker’s Healthcare Podcast

Episode Title: How Health Systems Are Reshaping Clinical Decision-Making by Turning Molecular Data into Actionable Care
Air Date: December 18, 2025
Host: Erica Spicer Mason (A)
Guest: Solomon Moshkovich (B), President of Clinical Diagnostics at Natera

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Episode Overview

This episode explores how health systems are harnessing molecular data to advance precision medicine and reshape clinical decision-making. Guest Solomon Moshkovich from Natera discusses breakthrough advancements in diagnostics and the integration of AI-driven tools, using real-world examples from cancer and chronic kidney disease care. The conversation highlights both the clinical and operational impacts of deploying molecular data for more personalized, efficient, and evidence-based care.

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Key Discussion Points & Insights

1. Natera’s Mission & Solomon’s Background

(00:43 – 01:52)

• Natera's Foundation: Founded by Stanford and MIT engineers, Natera has been innovating DNA analysis from blood for 20 years.
• Impact: Serves millions yearly in pregnancy, cancer, organ transplant, and chronic kidney disease diagnostics.
• Personal Commitment: Solomon, with a math background, emphasizes personal and organizational passion for patient impact.

2. Advancements in Precision Medicine

(02:38 – 06:39)

• Precision Oncology's Evolution: "The prior 10 years, I think, were full of discoveries about what you could do with information genomic profiling information from a tumor sample from a patient with cancer." (Solomon, 02:41)
• Targeted & Immunotherapy: Genetic profiling enables matched therapies; immunotherapies leverage the immune system.
• MRD Testing Breakthrough:
  • Molecular Residual Disease (MRD): Detects disease recurrence or remission by analyzing blood for tumor DNA.
  • Natera’s Signatera Test: Personalized for each patient, detecting unique cancer mutations with high specificity—finding recurrence a year before imaging.
  • Practice & Economic Impact: Changes oncology at scale, improves outcomes, avoids unnecessary treatments, and addresses healthcare costs.
• Evidence-based Integration: “We’re serving millions of patients every year and their physicians. These are medical tests ordered by physicians.” (Solomon, 01:21)

3. Integrating Molecular Diagnostics into Health Systems

(07:08 – 09:10)

• Challenges for Leaders:
  • Generating robust clinical evidence for new tests.
  • Integrating into workflows after evidence is established.
• Natera’s Solutions:
  • Significant investment in research and peer-reviewed validation ($500M+ annually).
  • Deploying AI-based systems to identify eligible patients and develop clinical decision support (CDS) tools.
  • Seamless EMR integration to track utilization and patient outcomes.
  • “We’re super excited about how AI enables us and our partners to accelerate that effort and, and ultimately improve patient care.” (Solomon, 08:56)

4. AI & Digital Tools in Translating Molecular Data

(09:10 – 14:25)

• Cancer Management Example:
  • Bladder Cancer & Signatera:
  • MRD-guided care, published in NEJM, increased survival by 40% in muscle-invasive bladder cancer using immunotherapy only in MRD-positive patients, sparing 50%+ of patients from unnecessary toxic and costly treatments.
  • “More than half of patients are negative for residual disease after surgery and can safely avoid treatment. Which is just incredible...” (Solomon, 09:58)
• Chronic Kidney Disease (CKD):
  • Rhena Site Test: Identifies germline mutations tied to CKD. CKD affects 40M+ Americans; genetic testing is shifting paradigms—like BRCA testing in oncology decades ago.
  • AI helps health systems identify, test, and treat overlooked CKD patients via EMR integration.
  • “Genetics in chronic kidney disease is where cancer was 20 years ago. And so there's going to be a sea change in how those patients are diagnosed and how they're managed based on their genetic status.” (Solomon, 11:13)
• Early Cancer Screening:
  • Blood-based Tests: New methylation-based tests are being developed for early detection of colorectal and other cancers in asymptomatic populations.
  • Focus on system-level deployment with AI to maximize early detection and positive outcomes.
  • "How do you deploy a population level test like that with the expectation that it's going to detect cancer at an earlier stage, which everyone knows is linked with better outcomes?" (Solomon, 13:36)

5. Broader Implications and Future Outlook

(14:25 – 16:51)

• Impact on Costs & Patient Experiences:
  • Precision diagnostics optimize resources and patient pathways; e.g., major reduction in unnecessary prenatal procedures due to Natera’s Panorama test.
  • "We've got a really bright future. So looking forward to continuing this conversation." (Solomon, 16:43)
• Patient-Centered Focus:
  • Many at Natera (employees and their families) have been direct beneficiaries of the technologies.
  • Numerous patient and physician testimonials illustrate real-world impact.
  • “I'm very, very optimistic about the next phase for Natera and for the precision medicine industry. Really like you said, optimizing the use of resources, getting treatment to patients who need it, and the right treatment at the right time, which takes precision diagnostics and also helping patients avoid unnecessary treatment or unnecessary interventions.” (Solomon, 15:38)

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Notable Quotes & Memorable Moments

• On MRD and Personalized Cancer Care:

  “Natera developed a test called the Signatera test, is the first ever in history personalized test for every single patient... The test can detect recurrence a year earlier than you'd see it on a scan and with extremely high specificity.”
  (Solomon, 04:40)

• On the Power of AI for Implementation:

  “That’s where Natera is partnering with Health Systems to deploy artificial intelligence based solutions to help identify the patients who are eligible... and really develop the clinical decision support tools and solutions that are going to improve adoption of evidence based medicine.”
  (Solomon, 07:51)

• On Cost-saving and Patient-centered Impacts:

  “Our Panorama non invasive prenatal test now has probably resulted in an over 80% reduction in amniocentesis and chorionic biopsy procedures across the country. It's just amazing.”
  (Solomon, 16:22)

• On the Industry's Future:

  "I'm very, very optimistic about the next phase for Natera and for the precision medicine industry... getting treatment to patients who need it, and the right treatment at the right time."
  (Solomon, 15:45)

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Key Timestamps

• 00:43 — Natera's background and mission
• 02:38 — Advancements in precision medicine and MRD
• 07:08 — Challenges for health systems integrating precision diagnostics
• 09:10 — AI's role in translating molecular data to care actions
• 09:38 — Example: Bladder cancer care transformation with MRD
• 11:50 — Example: Genetic testing in chronic kidney disease
• 13:50 — Example: Early cancer screening innovations
• 15:23 — Broader patient impact, Natera’s organizational culture
• 16:22 — Panorama test reducing prenatal invasive procedures

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Conclusion

This episode provides a deep dive into how advanced molecular diagnostics, enabled by AI and digital integration, are fundamentally shifting the clinical and economic landscape in U.S. healthcare. Through impactful real-world examples, Solomon Moshkovich illustrates how Natera and its partners are pioneering the future of precision medicine — increasing survival, improving patient experiences, and optimizing use of system resources. Listeners gain valuable, concrete insights into where the field stands today and where it is headed next.

Transcript

[A]

Hello, everyone. This is Erica Spicer Mason with Becker's Healthcare. Thank you so much for tuning into the Becker's Healthcare podcast series today. So today we're going to talk about how health systems are reshaping clinical decision making by turning molecular data into actionable care. And joining me for this conversation is Solomon Moshkovich, the president of Clinical Diagnostics at Natera Salomon. Welcome to the podcast. It's so great to have you with us today.

[B]

Thank you. It's great to be here.

[A]

Well, I'm excited to learn more about what's going on at Natera. And before we get into that conversation, I wanted to just learn a little bit more about you and your work in healthcare. Really feel free to share whatever you think would be helpful for our listeners to know.

[B]

Wonderful. Yeah. First, I want to introduce the company and I can talk about myself briefly. Natera has been around for about 20 years, started by engineers out of Stanford University and MIT. And the company has developed unique and patented technology for analyzing DNA from blood. And we've had an incredible impact. Now applying our technologies to improve care for pregnant women, for people with cancer, and for people with organ transplants and chronic kidney disease. We have a very significant pipeline to expand the applications for our technologies. And I'm very proud that we're serving millions of patients every year and their physicians. These are medical tests ordered by physicians. Myself, I've been at the company for almost 15 years, got a background in mathematics, and I'm very passionate about the impact that our technologies have on patients, including many in my own family. So I'm really glad to be here.

[A]

It's great to have you with us, Solomon, and I appreciate the overview about Natera and learning a little bit more about you as well. And it sounds like the company really is overseeing this technology that's helping a number of conditions and really important conditions for hospitals and health systems. When we're talking about, of course, pregnancy, cancer, chronic kidney disease. So excited to get some of your insights on that. But I want wanted to start a little bit high level and acknowledge that precision medicine, it's evolved rapidly in the last decade. I feel like every year we hear more about really impressive advancements in this field. So from your perspective, what are the most important advancements in how we identify disease status and guide care?

[B]

Yeah, this field has evolved so quickly. It's a very, very exciting time to, to be in genetics and genetic medicine and precision medicine. So the prior 10 years, I think, were full of discoveries about what you could do with information genomic profiling information from a tumor sample from a patient with cancer. And that led to really growth of the whole concept of precision oncology. If you find a certain mutation in a gene in the patient's cancer, that might mean that the patient is likely to benefit from a targeted therapy. For example, there's just been an explosion of different gene linked therapies from multiple different biopharma companies which have made a huge impact on patient survival. There's also been the introduction of immunotherapies and immuno oncology, unleashing the power of the patient, of the patient's own immune system to fight cancer. But the predictive tools for who is going to benefit, who needs additional therapy, who maybe does not need additional therapy and can avoid the unnecessary toxicity and cost of being on therapy sometimes for years, that has really not been acted upon until recently. And so the big new area of innovation in precision oncology specifically has been MRD testing. That's molecular residual disease testing. Natera is the leader in solid tumor mrd. I'll explain what the product does, but its purpose is to identify disease circulating in the blood and identifying which patients still have disease, residual disease MRD and need additional therapy and which patients maybe do not have detectable disease in their blood after some curative intervention and can safely avoid unnecessary therapy going forward and have amazing outcomes. Natera developed a test called the signatera test, is the first ever in history personalized test for every single patient. So the way that test works is that we, we do a whole exome or whole genome sequence of the tumor sample from resection or from biopsy. We identify the unique complement of mutations in that cancer that are not present in the background DNA. And then we custom design and manufacture a test for every single patient's cancer that only looks at that unique signature of mutations and looks for it in the blood, which is extremely highly specific. The test can detect recurrence a year earlier than you'd see it on a scan and with extremely high specificity. What that's enabled and that works across cancer types is extraordinary. That has enabled really a sea change in how oncology is practiced across the country and increasingly across the world, with huge implications for health economics as well as clinical outcomes. So I'm looking forward to getting to the discussion with you about how Natera is partnering with health systems and health system executives to make sure that these technologies are deployed in an evidence based way that not only improves patient care and outcomes, but also it makes a really big difference for the ballooning healthcare Costs in our country that has an implication not only in cancer, but in the other disease areas where we're operating. Yeah.

[A]

Solomon, thank you so much for the overview. It's really exciting to hear about these advancements and what's possible now in precision medicine and testing and diagnostics and, and as health systems. To your point, as they're looking more into how to integrate some of these innovations into routine care and routine decision making, what challenges are you seeing leaders face as they bring these more sophisticated tools into their clinical workflows?

[B]

Yeah, there's some significant challenges, but also with that comes huge opportunities. So the first step to integrating new diagnostics and new precision medicine tools into care is generating the clinical evidence. And that's an area that Natera and our partners have invested really significantly. We've got hundreds of peer reviewed papers and scientific presentations across not only cancer, but also detecting genetic abnormalities during pregnancy and identifying different predispositions towards chronic kidney disease and more. And so we've generated that evidence and we're continuing to invest now over half a billion dollars. That's with a B, over half a billion dollars this year and next year and going forward to continue driving that innovation and that evidence. But that's just the first step. So how do you integrate it into care once you're convinced you want it? And that's where Natera is partnering with Health Systems to deploy artificial intelligence based solutions to help identify the patients who are eligible for an intervention, eligible for a test, and really develop the clinical decision support tools and solutions that are going to improve adoption of evidence based medicine, identify gaps in care, integrate seamlessly with the electronic medical records or. Natera is already integrated as a clinical laboratory across really most of the systems across the country now and measure those outcomes and measure any gaps and potentially improvements in care from deploying these solutions. So we're super excited about how AI enables us and our partners to accelerate that effort and, and ultimately improve patient care.

[A]

Yeah, and I appreciate you touching on the role AI is playing here, Solomon, because I know that digital tools and AI are becoming more essential to helping clinicians also translate complex molecular data into those clear care pathways and next steps, as you've mentioned. So where are you seeing these technologies make the biggest difference right now and what opportunities do you think they present for the future of precision medicine?

[B]

Yeah, I'll give two examples, two or three examples that I think can really paint the picture of where things are going. The first is in cancer management. We just had a New England Journal of Medicine publication concurrent with a Major presentation at the European Society of Medical Oncology showing that MRD guided care that's using signatera, our MRD test, the signatera MRD guided care in the adjuvant setting for muscle invasive bladder cancer patients can improve overall survival by over 40% by treating MRD positive patients with immunotherapy and completely avoiding any adjuvant treatment for muscle invasive bladder cancer patients who are signetera negative and who stay negative after surgery. So that's more than half of patients are negative for their for residual disease after surgery and can safely avoid treatment. Which is just incredible because the, the prior standard of care is to treat all of those patients with immunotherapy for over a year, which is expensive, which is toxic and which we've proven is just unnecessary for most patients. So that's just one example. And then another example is in chronic kidney disease, this is now outside of cancer is a different test. It's called the rhena site test and that is a test for germline mutations that are associated with different types of chronic kidney disease. There's just been a significant inflection point in CKD recently which by the way affects over 40 million Americans have the diagnosis of chronic kidney disease and the goal is to avoid progressing to end stage renal disease and dialysis and needing an organ transplant. But in the past year and a half, the amount of evidence and new guideline recommendations for genetic testing of patients who have symptoms of kidney disease has increased significantly. So think of where like BRCA testing was 20 years ago for identifying patients who are predisposed towards breast cancer, ovarian cancer and other like inherited types of cancers. Genetics in chronic kidney disease is where cancer was 20 years ago. And so there's going to be a sea change in how those patients are diagnosed and how they're managed based on their genetic, their genetic status. So the challenge though for adoption in a system is okay, I've got some cases, over a million patients in my system who have various signs and symptoms of kidney disease and their records in the primary care setting might not even have a diagnosis of ckd, but they have symptoms. So how do you go and identify those patients who need to get a test and actually get them that care? How do you close that care gap? And that's where these digitally enabled and AI driven solutions start to play a big role. So we're excited to part, we're partnering with several different systems right now to identify those patients in an intelligent EMR integrated manner and to get them tested and Then get them the right intervention, depending on the result of that test. I think that's two examples. I'll just plug one other one and that is early cancer screening. There's been a really exciting innovation in the field doing blood based cancer testing to find colorectal cancer and soon other cancer types as well for patients who are otherwise asymptomatic. So how do you do that? Right. How do you deploy a population level test like that with the expectation that it's going to detect cancer at an earlier stage, which everyone knows is linked with better outcomes? And again, that's an area where Natera is taking a leadership approach both with developing what we believe is going to be a leading performance early cancer test based on methylation technology, as well as the smartest ways to partner with systems to actually deploy that technology to help their patients at a wide scale. Those are three good examples of how we're approaching this.

[A]

Yeah, I really appreciate the clear examples too. Solomon. These are great. As you were explaining all of these advancements and what's on the horizon here, just the sheer number of patients at the population level this could impact is. It sounds remarkable. And I also, to your first point, or your first example, mentioning how these innovations could help with, I can't think of another word for it, but kind of prudent use of resources in the healthcare environment, which is so important from a cost perspective. It's just interesting to see how this affects everything from cost to patient journey to health outcomes and you know, that upstream approach to preventing conditions like cancer. So again, I so appreciate the examples. I think that's really helpful for myself and for listeners. But before I let you go today, you know, is there anything else that you wanted to share that maybe we haven't touched on yet? Whether it's a final takeaway or maybe anything exciting on the horizon for Natera?

[B]

Yeah, ultimately Natera is a highly patient centered organization. We employ over 6,000amazing talented scientists, engineers and more. And the number of people at our company who have either directly benefited from our technologies or have family members who have benefited is extraordinary. And you can visit our website and see so many patient testimonials and physician testimonials about how our technologies have impacted care and improved patients lives. So I'm really proud of that and I'm very, very optimistic about the next phase for Natera and for the precision medicine industry. Really like you said, optimizing the use of resources, getting treatment to patients who need it, and the right treatment at the right time, which takes precision diagnostics and also helping patients avoid unnecessary treatment or unnecessary interventions when it's not necessary. It's something that we accomplished in prenatal testing where our Panorama non invasive prenatal test now has probably resulted in an over 80% reduction in amniocentesis and chorionic biopsy procedures across the country. It's just amazing and so I'm proud of what we do and we've got a really bright future. So looking forward to continuing this conversation.

[A]

Oh likewise Solomon. We're excited to keep tabs on Atera and all of the developments ahead and your passion comes through throughout this whole conversation about the work that you do and that your team is doing. So I just want to thank you for making the time for Beckers today and sharing your insights with us.

[B]

Thank you so much.

[A]

We'd also like to thank our podcast sponsor for today's episode. Natera listeners, be sure to tune into more podcasts from Becker's by visiting our podcast [e-mail].