Building with Twinome · San Diego, California
Come build the layer that decides what happens next.
Twinome AI is building a medication intelligence network: a patient-controlled identity and consent layer, multimodal ingestion of genomic, clinical, pharmacy, claims, wearable and patient-reported data, and an explainable decision engine that sits inside the clinician's real workflow. The company enters through pharmacogenomics — a market with clinical evidence, regulatory recognition and existing payer channels — and expands into the far larger business of being the trusted layer between a person's biology and every prescription they will ever receive.
What Twinome is
Three things, and each one only works because of the one before it.
Twinome is not a test and it is not a connector. It is the intelligence layer that sits above a person's medication life and decides what should happen next — then makes that thing possible in the same moment.
The credential
The Medication Passport
A portable, person-owned record of what someone takes, what they have taken, and what their biology says about it. A pass, not a portal — it travels to the pharmacy counter, the clinician's system and the apps that already have their attention.
The intelligence
The context layer
Genomic, clinical, pharmacy, lab and behavioural signals resolved into one computable picture, then turned into a defensible recommendation. Not a test result. A decision, with the evidence behind it.
The network
The action network
The moment context becomes a decision, something should happen — a switch, a dose change, a test, a referral, a fill. Twinome routes that action and earns on it. Every completed action makes the next recommendation better.
PGx / data import
Entry wedge
Medication Passport
Persistent interface
Longitudinal context
The record deepens
Medication intelligence
Normalisation, risk, relevance
Action Engine
Is this relevant now?
Relevant next action
The user chooses
Partner / provider / pharmacy / trial
Fulfilment by licensed third parties
Revenue
Performance, contract or retained margin
Outcome data
What actually happened
- Outcome data returns to the intelligence layer.
Why this matters
The largest thing medicine does at scale, and nobody has built the brain for it.
This is not a feature inside someone else's product. It is an open position in the middle of the health system, and the window to take it is now.
$606B
U.S. medicine spending at net prices, 2025
Up 10.6% on 2024 — the fastest growth in five years.
11
Places a person's medication context already lives
Genomics, pharmacy, claims, labs, records, wearables. Nothing sits above them.
0
Companies that own the decision layer
Testing companies stop at the result. Connectors stop at the pipe.
Who you would be building with
Build alongside people who have already done it at hyperscale.
The seats below are confirmed. Pedigree is shared here; names are shared in the room. Every one of these people has built at a scale most companies never reach — and chose to build this next.
Ben Sperling
Chief Executive Officer
Builds healthcare intelligence businesses from zero — and scales them past their targets.
The team is deliberately small and deliberately senior. Every seat is a decision-maker, and the standard is the same in each one: people who have built the thing before at scale, and want to build the better version of it here. You would not be joining a company looking for its footing — you would be joining a room that already knows how this is done.
How we work
How we operate.
Clinical truth beats product velocity
Nothing ships that we cannot defend to a pharmacist, a prescriber and a regulator. Evidence standards are a product requirement here, not a compliance afterthought.
The person owns their record
Consent is explicit, revocable and per-use. We build the credential the way we would want ours built.
Small team, unusual leverage
Every seat is a decision-maker. You will own a surface end to end, and you will see it move the company within a quarter.
Craft is not decoration
This is a health product people will hold at a pharmacy counter under stress. Clarity is a safety feature.
The opportunity
The seats that will define the company.
These are not staffing gaps. Each of these people will set the standard for their function for the next decade and build the team beneath them from scratch.
Executive seats are being published shortly.
What happens next
The conversation is the next step.
This page exists so that the time we spend together is spent on the interesting part. You already have the shape of what we are building — come with the hard questions.
What we will want to understand
How you think, not what you have memorised. Bring the hardest problem you have owned, what you got wrong in it, and what you would do differently with the same brief today.
What you should press us on
The model, the evidence standard, the regulatory boundaries, the sequencing, and what happens if the first vertical does not work. Every one of those has an answer, and you should make us give it.
How this usually goes
A working conversation rather than an interview loop — the scope of the seat, the first ninety days, and whether the two of us would build well together.
Every prescription is a prediction. We are building the layer that makes it a better one — from San Diego, with a very small number of people.