Imagine a future, maybe 20-25 years from now, when there’s a smart toilet in every home. Picture it: the smart toilet, a device that collects our fecal matter and provides information about our health via our microbiome.

The human gut microbiome is a complex ecosystem (consisting of trillions of bacteria, viruses, fungi) that is receiving increasing attention for the role it plays in our health. Gut microbes help regulate our metabolism, ward off infections, break down fiber, and may be biomarkers of health and disease. Numerous studies have shown changes in gut microbes during obesity, diabetes, liver disease, cancer and neurodegenerative disease.

Yet despite this, we are still far away from a smart toilet. Yes, some microbiome tests exist today. And some companies claim to improve your health by prescribing probiotics and suggesting diet changes based on your fecal sample. But so far, these “solutions” have little backing from the medical world. Few physicians order these tests for patients and few payers reimburse. But with that said, what’s important is that we are starting to collect information about our microbiome.

Today, there’s sound science for sequencing fecal samples to give you a count of specific bacteria. However, there’s very little scientific evidence correlating bacteria to your health. That’s because gut health is all relative: what is healthy for you is different from what is healthy for me. As such, you need a frequent and long-term sampling of your gut microbiome in order to track how any changes correlate to any symptoms you are experiencing. But herein lies the problem: just collecting one fecal sample is full of friction (who likes touching their feces?) – so imagine how unpleasant the UX is for collecting longitudinal data.

Working backwards, we can think about how to get to a smart toilet…

If the goal of the smart toilet is to tell us about our gut health so that we can make changes to our lifestyle and be healthier, then what we need are:

• Implanted assays in the toilet for immediate analysis/diagnosis, which require:
• FDA approval for these assays developed as a result of proving a correlation between the microbiome and certain diseases, which is possible when there is:
• A frictionless sample collection device that can collect longitudinal data for researchers to conduct their microbiome studies.

And what might a smart toilet business look like? Is it vertically integrated? Could the toilet be like a smartphone (hardware) with a software platform where people can build “apps” (assays) to test for particular diseases?

Should the company be B2C so that it can completely own the data? That seems logical, but how does one launch a B2C if there’s no immediate value (i.e. correlation to health) to provide the customer on Day 1?

What about a B2B model? Does this make more sense at first? Perhaps it starts with empowering researchers to find a correlation between the microbiome and disease with an easy-for-patients-to-use tool. On this point, companies like BiomeSense are building a collection device that attaches to the toilet so patients don’t have to swab themselves or defecate in a cup. The question then becomes how one goes beyond being just a collection company (which would likely become a commodity)? What value-add can be provided? Perhaps analysis?

Clearly, this is all a simplified look and there are many more steps involved, questions to answer, and challenges to consider. And the entire model is precipitated on the fact that we believe in the potential of microbiome to tell us about our metabolism and health. I, for one, am convinced that this hypothesis is true.

Is anyone thinking about this? I’d love to speak with any entrepreneurs, investors, scientists, and doctors, who have a similar vision.