What tech gets right about healthcare

Why is tech still aiming for the healthcare industry? It seems full of endless regulatory hurdles or stories of misguided founders with no knowledge of the space, running headlong into it, only to fall on their faces.

Theranos is a prime example of a founder with zero health background or understanding of the industry — and just look what happened there! The company folded not long after founder Elizabeth Holmes came under criminal investigation and was barred from operating in her own labs for carelessly handling sensitive health data and test results.

But sometimes tech figures it out. It took years for 23andMe to breakthrough FDA regulations — it’s since more than tripled its business and moved into drug discovery.

And then there’s Oscar Health, which first made a mint on Obamacare and has since ventured into Medicare. Combined with Bright, the two health insurance startups have pulled in a whopping $3 billion so far.

It’s easy to shake our fists at fool-hardy founders hoping to cash in on an industry that cannot rely on the old motto “move fast and break things.” But it doesn’t have to be the code tech lives or dies by.

So which startups have the mojo to keep at it and rise to the top? Venture capitalists often get to see a lot before deciding to invest. So we asked a few of our favorite health VC’s to share their insights.

Phin Barnes – First Round Capital

Calling all hardware startups! Apply to Hardware Battlefield @ TC Shenzhen

Got hardware? Well then, listen up, because our search continues for boundary-pushing, early-stage hardware startups to join us in Shenzhen, China for an epic opportunity; launch your startup on a global stage and compete in Hardware Battlefield at TC Shenzhen on November 11-12.

Apply here to compete in TC Hardware Battlefield 2019. Why? It’s your chance to demo your product to the top investors and technologists in the world. Hardware Battlefield, cousin to Startup Battlefield, focuses exclusively on innovative hardware because, let’s face it, it’s the backbone of technology. From enterprise solutions to agtech advancements, medical devices to consumer product goods — hardware startups are in the international spotlight.

If you make the cut, you’ll compete against 15 of the world’s most innovative hardware makers for bragging rights, plenty of investor love, media exposure and $25,000 in equity-free cash. Just participating in a Battlefield can change the whole trajectory of your business in the best way possible.

We chose to bring our fifth Hardware Battlefield to Shenzhen because of its outstanding track record of supporting hardware startups. The city achieves this through a combination of accelerators, rapid prototyping and world-class manufacturing. What’s more, TC Hardware Battlefield 2019 takes place as part of the larger TechCrunch Shenzhen that runs November 9-12.

Creativity and innovation no know boundaries, and that’s why we’re opening this competition to any early-stage hardware startup from any country. While we’ve seen amazing hardware in previous Battlefields — like robotic armsfood testing devicesmalaria diagnostic tools, smart socks for diabetics and e-motorcycles, we can’t wait to see the next generation of hardware, so bring it on!

Meet the minimum requirements listed below, and we’ll consider your startup:

Here’s how Hardware Battlefield works. TechCrunch editors vet every qualified application and pick 15 startups to compete. Those startups receive six rigorous weeks of free coaching. Forget stage fright. You’ll be prepped and ready to step into the spotlight.

Teams have six minutes to pitch and demo their products, which is immediately followed by an in-depth Q&A with the judges. If you make it to the final round, you’ll repeat the process in front of a new set of judges.

The judges will name one outstanding startup the Hardware Battlefield champion. Hoist the Battlefield Cup, claim those bragging rights and the $25,000. This nerve-wracking thrill-ride takes place in front of a live audience, and we capture the entire event on video and post it to our global audience on TechCrunch.

Hardware Battlefield at TC Shenzhen takes place on November 11-12. Don’t hide your hardware or miss your chance to show us — and the entire tech world — your startup magic. Apply to compete in TC Hardware Battlefield 2019, and join us in Shenzhen!

Is your company interested in sponsoring or exhibiting at Hardware Battlefield at TC Shenzhen? Contact our sponsorship sales team by filling out this form.

Google’s SMILY is reverse image search for cancer diagnosis

Spotting and diagnosing cancer is a complex and difficult process even for the dedicated medical professionals who do it for a living. A new tool from Google researchers could improve the process by providing what amounts to reverse image search for suspicious or known cancerous cells. But it’s more than a simple matching algorithm.

Part of the diagnosis process is often examining tissue samples under a microscope and looking for certain telltale signals or shapes that may indicate one or another form of cancer. This can be a long and arduous process because every cancer and every body is different, and the person inspecting the data must not only look at the patient’s cells but also compare them to known cancerous tissues from a database or even a printed book of samples.

As has been amply demonstrated for years now, matching similar images to one another is a job well suited to machine learning agents. It’s what powers things like Google’s reverse image search, where you put in one picture and it finds ones that are visually similar. But this technique has also been used to automate processes in medicine, where a computer system can highlight areas of an X-ray or MRI that have patterns or features it has been trained to recognize.

That’s all well and good, but the complexity of cancer pathology rules out simple pattern recognition between two samples. One may be from the pancreas, another from the lung, for example, meaning the two situations might be completely different despite being visually similar. And an experienced doctor’s “intuition” is not to be replaced, nor would the doctor suffer it to be replaced.

Aware of both the opportunities and limitations here, Google’s research team built SMILY (Similar Medical Images Like Yours), which is a sort of heavily augmented reverse image search built specifically for tissue inspection and cancer diagnosis.

A user puts into the system a new sample from a patient — a huge, high-resolution image of a slide on which a dyed section of tissue is laid out. (This method is standardized and has been for a long time — otherwise how could you compare any two?)

smilygif

Once it’s in the tool, the doctor can inspect it as they would normally, zooming in and panning around. When they see a section that piques their interest, they can draw a box around it and SMILY will perform its image-matching magic, comparing what’s inside the box to the entire corpus of the Cancer Genome Atlas, a huge database of tagged and anonymized samples.

Similar-looking regions pop up in the sidebar, and the user can easily peruse them. That’s useful enough right there. But as the researchers found out while they were building SMILY, what doctors really needed was to be able to get far more granular in what they were looking for. Overall visual similarity isn’t the only thing that matters; specific features within the square may be what the user is looking for, or certain proportions or types of cells.

As the researchers write:

Users needed the ability to guide and refine the search results on a case-by-case basis in order to actually find what they were looking for…This need for iterative search refinement was rooted in how doctors often perform “iterative diagnosis”—by generating hypotheses, collecting data to test these hypotheses, exploring alternative hypotheses, and revisiting or retesting previous hypotheses in an iterative fashion. It became clear that, for SMILY to meet real user needs, it would need to support a different approach to user interaction.

To this end the team added extra tools that let the user specify much more closely what they are interested in, and therefore what type of results the system should return.

First, a user can select a single shape within the area they are concerned with, and the system will focus only on that, ignoring other features that may only be distractions.

Second, the user can select from among the search results one that seems promising and the system will return more like it, less closely tied to the original query. This lets the user go down a sort of rabbit hole of cell features and types, doing that “iterative” process the researchers mentioned above.

refinements

And third, the system was trained to understand when certain features are present in the search result, such as fused glands, tumor precursors, and so on. These can be included or excluded in the search — so if someone is sure it’s not related to this or that feature, they can just sweep all those examples off the table.

In a study of pathologists given the tool to use, the results were promising. The doctors appeared to adopt the tool quickly, not only using its official capabilities but doing things like reshaping the query box to test the results or see if their intuition on a feature being common or troubling was right. “The tools were preferred over a traditional interface, without a loss in diagnostic accuracy,” the researchers write in their paper.

It’s a good start, but clearly still only an experiment. The processes used for diagnosis are carefully guarded and vetted; you can’t just bring in a random new tool and change up the whole thing when people’s lives are on the line. Rather, this is merely a bright start for “future human-ML collaborative systems for expert decision-making,” which may at some point be put into service at hospitals and research centers.

You can read the two papers describing SMILY and the doctor-focused refinements to SMILY here; they were originally presented at CHI 2019 in Glasgow earlier this year.

Elon Musk’s Neuralink looks to begin outfitting human brains with faster input and output starting next year

Neuralink, the Elon Musk-led startup that the multi-entrepreneur founded in 2017, is working on technology that’s based around ‘threads’ which it says can be implanted in human brains with much less potential impact to the surrounding brain tissue vs. what’s currently used for today’s brain-computer interfaces. “Most people don’t realize, we can solve that with a chip,” Musk said to kick off Neuralink’s event, talking about some of the brain disorders and issues the company hopes to solve.

Musk also said that long-term Neuralink really is about figuring out a way to “achieve a sort of symbiosis with artificial intelligence.” “This is not a mandatory thing,” he added. “This is something you can choose to have if you want.”

For now, however, the aim is medical and the plan is to use a robot that Neuralink has created that operates somewhat like a “sewing machine” to implant this threads, which are incredibly thin I(like, between 4 and 6 μm, which means about one-third the diameter of the thinnest human hair), deep within a person’s brain tissue, where it will be capable of performing both read and write operations at very high data volume.

All of this sounds incredibly far-fetched, and to some extent it still is: Neuralink’s scientists told The New York Times in a briefing on Monday that the company has a “long way to go” before it can get anywhere near offering a commercial service. The main reason for breaking cover and talking more freely about what they’re working on, the paper reported, is that they’ll be better able to work out in the open and publish papers, which is definitely an easier mode of operation for something that requires as much connection with the academic and research community as this.

Neuralink1

Neuralink co-founder and president Max Hodak told the NYT that he’s optimistic Neuralink’s tech could theoretically see use somewhat soon in medical use, including potential applications enabling amputees to regain mobility via use of prosthetics and reversing vision, hearing or other sensory deficiencies. It’s hoping to actually begin working with human test subjects as early as next year, in fact, including via possible collaboration with neurosurgeons at Stanford and other institutions.

The current incarnation of Neuralink’s tech would involve drilling actual holes into a subject’s skull in order to insert the ultra thin threads, but future iterations will shift to using lasers instead to create tiny holes that are much less invasive and essentially not felt by a patient, Hodak told the paper. Working on humans next year with something that meets this description for a relatively new company might seem improbable, but Neuralink did demonstrate its technology used on a laboratory rat this week, with performance levels that exceed today’s systems in terms of data transfer. The data from the rat was gathered via a USB-C port in its head, and it provided about 10x more what the best current sensors can offer, according to Bloomberg.

Neurlalink’s advances vs. current BCI methods also include the combined thinness and flexibility of the ‘threads’ used, but one scientist wondered about their longevity when exposed to the brain, which contains a salt mix fluid that can damage and ultimately degrade plastics over time. The plan is also that the times electrodes implanted in the brain will be able to communicate wirelessly with chips outside the brain, providing real time monitoring with unprecedented freedom of motion, without any external wires or connections.

Elon Musk is bankrolling the majority of this endeavour as well as acting as its CEO, with $100 million of the $158 million its raised so far coming from the SpaceX and Tesla CEO. It has 90 employees thus far, and still seems to be hiring aggressively based on its minimal website (which basically only contains job ads). Elon Musk also noted at the outset of today’s presentation that the main reason for the event was in fact to recruit new talent.

How to watch Elon Musk’s Neuralink brain control interface startup presentation live

One of Elon Musk’s stealthier endeavors is set to become a lot less stealthy tonight, with a presentation set for 8 PM PT (11 PM ET) streaming live from its website in which we’ll learn a lot more about Neuralink, the company Musk founded in 2017 to work on brain control interfaces (BCIs) and essentially part of his larger strategy to help mitigate the risks of AI and enhance its potential benefits.

Here’s what we do know about Neuralink already: Its initial goal, at least as of two years ago, was to figure out how brain interfaces could be helpful in alleviating the symptoms of chronic medical conditions, including epilepsy. This goal will involve the development of “ultra high bandwidth brain-machine interfaces to connect humans and computers,” which is the only formal description Neuralink provides of its overall mission on its own website.

In a post on Wait Buy Why back when the company first broke cover, we got a lot more in-depth background about what problem Musk wants to solve and why. Summarized, Neuralink’s mission is very much on trend with Musk’s other ventures, in that it hopes to help humans avoid something he perceives as an existential threat in order that we may survive, thrive and I guess come up with other potential existential threats for him to also then solve.

Ultimately, Neuralink seems to be aiming well beyond its initial exploration of medical technology, which was really just a way to potentially get testing faster with a practical application that’s easier to work with in terms of rules and regulators. Musk’s goal, per the Wait But Why explainer, is actually to eliminate the “compression” that happens when we translate our thoughts into language, and then into input via keyboard, mouse, etc. before actually transmitting it to a computer. Taking away the need to compress and then decompress the signal, in other words, will make communication between people and computers much faster, lossless and very high bandwidth.

This has an existential angle because this is a key step, Musk believes, in ensuring that humanity can keep up with the increasingly advanced AI it’s developing. So to avoid a doomsday scenario where the robots take over, basically Musk proposes more or less mind-melding with the robots instead.

That was a lot to digest two years ago — it’s wild to think about what Neuralink may have done in the interim to work toward or modify this goal. Luckily, we won’t have to wait much longer. That stream kicks off at 8 PM PT (11 PM ET) and will be carried live on Neuralink.com. We’ll update this post if there’s a direct stream, too.

Elon Musk-backed Neuralink to detail its progress on upgrading the brain to keep pace with AI

Elon Musk’s brain computer interface (BCI) venture Neuralink will provide some more insight into what they’ve been working on for the past two years, during which time we’ve heard very little in the way of updates on their progress. In 2017, we learned that Neuralink’s overall driving mission was to help humans keep pace with rapid advancements in AI, ensuring that we can continue to work with ever-more advanced technology, by closing the input and output gap between ourselves and computers.

Musk has famously forewarned of the potential dangers of artificial intelligence, and what happens when it becomes more powerful relative to out own ability to control and understand it. He also founded OpenAI alongside Sam Altman and others as a research organization hoping to collaborate on the development of AI specifically designed to benefit, not harm humanity.

At Recode’s Code conference in 2016, and again in 2017 at an event in Dubai, Musk discussed how BCI could help people communicate with computers with much higher bandwidth and lower latency than is possible now, using our relatively primitive input methods (keyboard, mice and touch all introduce a surprising amount of lag and fidelity loss if you think about it).

Neuralink seems to be Musk’s long-term play to help bridge this gap, which basically amounts to an effort to accelerate the kind of ‘singularity’ moment advocated by Ray Kurzweil and others wherein humanity effectively merges with technology as a new stage of engineered evolution. In the interim, however, it originally set its sights on addressing medical conditions including epilepsy and clinical, chemical depression via implanted brain interfaces, as a stepping stone to its more ambitious and more broadly applicable goals for BCI.

This update from Neuralink should shed light on where they are with that approach (if that’s even still the approach), and who knows: we might even get a clue as to how and when we can expect to truly become one with our computers.

After selling Auris for $3.4 billion to J&J, CEO Frederic Moll and lead investor Ajay Royan come to Disrupt

Frederic Moll has to be one of the most successful inventors and entrepreneurs who is not yet a household name.

Moll’s successes include the 22-year-old, publicly traded Intuitive Surgical, a robotic surgical systems manufacturer now worth around $61.4 billion, and Hansen Medical, a company that developed tools to manipulate catheters.

Most recently, the serial medical device entrepreneur sold Auris, a manufacturer of advanced surgical robots that was sold earlier this year to Johnson & Johnson in a $3.4 billion deal that also holds the possibility of an additional $2.35 billion in payouts.

More significant than the money, though, are the changes that technologies like Auris presage for the medical profession.

“With Auris, we realized there aren’t going to be enough surgeons to address the needs of the additional 5 billion people who are going to be on earth, and everyone deserves equally good healthcare, and you’ve got to find a way to deliver that with technology. So, what is the equivalent of cell phones for surgery?” said Ajay Royan, the co-founder of Mithril Capital and an investor in the company, in an interview with Fortune earlier this year. “It sounds crazy, but what is the iPhone of surgery, where you can deliver an insanely sophisticated platform but be able to operate it in a very intuitive and simple fashion? That was the thesis behind Auris; it was not an instrument that we were funding, we were funding a platform and a way of training people in surgery.”

Royan, who co-founded Mithril Capital with Peter Thiel back in 2014, saw in Auris a startup that epitomized his firm’s approach to investments. It led Mithril to back the company and paved the way for what looks like a $700 million windfall for the fund.

Mithril closed its second fund with $850 million roughly two years ago and has been methodically investing in a wide range of companies that include the intelligence data mining company Palantir, along with big swings in robotics companies around the world.

Mithril invested $140 million into a Singapore and Gurugram-based startup, GreyOrange, and the Miami-based dental surgical robotics company, Neocis.

Expect to hear updates on investment in robotics, disruptions in the medical device world and much, much more at Disrupt SF in October when these two titans take the stage.

Disrupt SF runs October 2 – October 4 at the Moscone Center in San Francisco. Tickets are available here.

Chan-Zuckerberg Initiative gives $68M to fund Human Cell Atlas projects

An ongoing global project to map the human body cell by cell has receive a $68 million shot in the arm from the Chan-Zuckerberg Initiative. It will support dozens of individual projects contributing to the eponymous atlas of human cells.

The Human Cell Atlas is a collection of projects that aim to document healthy human cells at about as detailed a level as is practical. And CZI has been supporting it for a few years in various ways as part of its ongoing philanthropic work in basic research.

In fact CZI announced that it would be backing these 38 three-year projects some time back, along with 85 one-year projects along the same lines. But the grants process moves slowly, since everything has to be approved, estimated, and arranged beforehand — it’s rare a scientist or lab just gets a blank check for whatever they feel like doing.

The $68 million figure, however, is new, and better delineates the scope of CZI’s involvement with the HCA. The actual projects being backed can be explored here, down to the researchers and institutions responsible for them.

The results of the work and tools created to enable it will be made available freely to other researchers — another priority of CZI is open source software and datasets.

“We’re excited to further support and build interdisciplinary collaborations that will accelerate progress towards a first draft of the Human Cell Atlas,” said CZI’s head of science Cori Bargmann in a press release. It’s a big job, all right. We’ll check back in a few years to see how they’re getting on.

A widely used infusion pump can be remotely hijacked, say researchers

A hospital infusion pump widely used in hospitals and medical facilities has critical security flaws that allow it to be remotely hijacked and controlled, according to security researchers.

Researchers at healthcare security firm CyberMDX found two vulnerabilities in the Alaris Gateway Workstation, developed by medical device maker Becton Dickinson.

Infusion pumps are one of the most common bits of kit in a hospital. These devices control the dispensing of intravenous fluids and medications, like painkillers or insulin. They’re often hooked up to a central monitoring station so medical staff can check on multiple patients at the same time.

But the researchers found that an attacker could install malicious firmware on a pump’s onboard computer, which powers, monitors and controls the infusion pumps. The pumps run on Windows CE, commonly used in pocket PCs before smartphones.

In the worst case scenario, the researchers said it would be possible to adjust specific commands on the pump — including the infusion rate — on certain versions of the device by installing modified firmware.

The researchers said it was also possible to remotely brick the onboard computer, knocking the pump offline.

The bug was scored a rare maximum score of 10.0 on the industry standard common vulnerability scoring system, according to Homeland Security’s advisory. A second vulnerability, scored at a lesser 7.5 out of 10.0 could allow an attacker to gain access to the workstation’s monitoring and configuration interfaces through the web browser.

The researchers said creating an attack kit was “quite easy” and “worked consistently,” said Elad Luz, CyberMDX’s head of research, in an email to TechCrunch. But the attack chain is complex and requires multiple steps, access to the hospital network, knowledge of the workstation’s IP address, and the capability to write custom malicious code.

In other words, there are far easier ways to kill a patient than exploiting these bugs.

CyberMDX disclosed the vulnerabilities to Becton Dickinson in November and to federal regulators.

Becton Dickinson said device owners should update to the latest firmware, which contains fixes for the vulnerabilities. Spokesperson Troy Kirkpatrick said the pump is not sold in the U.S., but would not say how many devices were vulnerable “for competitive reasons.”

“There are about 50 countries that have these devices,” said Kirkpatrick. He confirmed that eight countries that have more than 1,000 devices, three countries have more than 2,000 devices, but no country has more than 3,000 devices.

The flaws are another reminder that security issues can exist in any device — particularly life-saving equipment in the medical space.

Earlier this year, Homeland Security warned about a set of critical-rated vulnerabilities in Medtronic defibrillators. The government-issued alert said the device’s proprietary radio communications protocol did not require authentication, allowing a nearby attacker in certain circumstances to intercept and modify commands over-the-air.

Neurobehavioral health company Blackthorn pulls in $76 million from GV to treat mental disorders

There are numerous challenges to finding effective treatments for mental disorders. However, Blackthorn Therapeutics, a neurobehavioral health company using machine learning to create personalized medicine for mental health, is betting its technological approach to finding drugs that work will put it ahead of the competition. Lucky for them, GV and other biotech investors have shown they agree by adding another $76 million in Series B financing to the coffers.

Today, Blackthorn announced the close of its $76 million series B round from GV, Scripps Research, Johnson & Johnson Innovation and a bevy of other biotech investment firms, including Polaris Partners, Premier Partners, Vertex Ventures HC, Alexandria Venture Investments, Altitude Life Science Ventures, ARCH Venture Partners, and Biomatics Capita.

Blackthorn has been heads down the last couple of years on a clinical trial for a drug that could potentially treat mood disorders. In April, the company announced positive results from its phase I trial for the drug.

The company plans to use the funding to advance its clinical-stage programs for mood disorders as well as for potential treatment of autism spectrum disorder, advancing towards clinical investigation in 2020.

Brian Chee, a managing partner at Polaris Partners, Lori Hu, a managing director at Vertex Ventures HC, and Julie Sunderland, a managing director at Biomatics Capital have joined Blackthorn’s board as directors in conjunction with the funding.

Blackthorn also recently added two people to its executive team. Jane Tiller has joined as chief medical officer and Laura Hansen as vice president, corporate affairs.

“BlackThorn was founded to bring new therapies to patients by applying advances in computational sciences to address patient heterogeneity, one of the biggest historical challenges in the field of neuropsychiatric drug development,” said Blackthorn’s president and COO Bill Martin, Ph.D. “Three years later, insights from our data-driven approaches are yielding patient enrichment strategies that could increase probability of clinical trial success and improve patient outcomes. We are grateful for our investors’ support to continue advancing our platform and therapeutic pipeline as we build out a world-class team at the intersection of technology and clinical neuroscience.”