Paige details first AI pathology tech with clinical-grade accuracy in new research paper

Medical tech and computational pathology startup Paige has published a new article in the peer-reviewed medical journal Nature Medicine, detailing its artificial intelligence-based detection system for identifying prostate cancer, skin cancer and breast cancer, which the company says achieves “near-perfect accuracy.” Paige’s tech, which employs deep learning trained on a dataset of almost 45,000 slide images taken from over 15,000 patients spanning 44 countries, is novel in that it can eschew the need to curate data sets for training first, which greatly decreases cost and time required to build accurate AI-based diagnostic tools.

Last February, Paige announced $25 million in Series A funding, and a partnership with Memorial Sloan Kettering Center (MSK) to gain access to one of the largest single repositories of pathology slides in the world. MSK is also home to the lab of Dr. Thomas Fuchs, Paige’s co-founder and Chief Scientific Officer, and possibly the world’s foremost authority in computational pathology.

Paige’s approach uses much larger data sets than are typically employed in AI-based diagnostics, but without the tight curation that focuses other efforts much more narrowly on specific types of cancer diagnostics. The result, according to the company, is not only better performance, but also a resulting system that its much more generally applicable.

Next up for Paige is to commercialize its technology, which is something it’s already pursuing. The work described in the article published in Nature Medicine has already been employed in technology currently under review by the FDA, albeit for a different final application than the ones described in the study published by the magazine.

 

Brave Care, backed by Y Combinator, is an urgent care clinic just for kids

Brave Care is an urgent care facility for pediatric care that costs, on average, about 80% less than a pediatric ER visit. Darius Monsef and his co-founder came up with the idea shortly after a fateful week for the Monsef family, during which their four-year-old dove off a bike ramp and their one-year-old started having breathing problems.

For both visits, he went to a pediatric urgent care facility where his kids were thoughtfully and patiently treated by Dr. Corey A. Fish. Monsef and Fish went to coffee a couple of weeks later, and Fish revealed he wanted to build out more pediatric urgent cares but needed a business partner.

The duo brought on a COO, Maryam Taheri, and a CTO, Asa Miller, and Brave Care was born.

In 2015, there were approximately 30 million pediatric emergency room visits in the United States — 96.7% of them were treat-and-release visits.

It’s no surprise that parents are quick to pull the trigger on an emergency room visit when their kid is hurt or injured. But ER visits are incredibly expensive, leaving caring parents in a punishing situation.

The idea behind Brave Care is to provide a service that fits in between a child’s regular doctor and the emergency room.

“We don’t want the treatment of an injury or illness to be more traumatic than how you got it,” said Monsef.

Brave Care is built specifically for children, meaning that the waiting rooms are kid-friendly and the medical instruments are kid-sized and not intimidating. Plus, Brave Care goes the extra step to make sure little patients aren’t afraid, whether that means numbing gels for injections or offering medicine in liquid form.

For now, Brave only has one location, in the Portland area, but the vision is to expand the brand to many locations across the country. Brave also wants to introduce a triage tool to help parents at home who are making difficult decisions about what to do with a sick or injured kid.

“One thing parents often do is they try to Google for whatever symptom or problem their kid is having,” said Monsef. “And searching for a problem is pretty awful because search engines are trained to return the most interesting result, and I don’t want that. That’s terrifying. What I want is to reasonably narrow down the area of the problem so I can find a better answer.”

He went on to explain that sometimes it can be very difficult to search a symptom without the right terminology. For example, how do you describe a certain type of cough?

In the near future, Brave Care wants to introduce a self-guided triage tool for parents looking to understand the basics of the issue so they can make informed decisions on where they need to go, what they need to do and how urgently they need to do it.

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The triage product is currently in development and will launch soon.

Eventually, Monsef sees the opportunity to introduce an asynchronous telemedicine product, which would combine in a HIPAA-compliant messaging system the data collected from the self-serve triage tool with pictures and videos provided by the parent.

That said, Monsef believes that fully remote telemedicine leads to overprescription of antibiotics and says Brave Care will stay away from remote-only care in the short term.

“Without the right device in a consumer’s hand, there isn’t much we can do remotely,” said Monsef. “We can’t look in the ear or throat, or listen to the heart. But as consumers get more of these devices, we can improve remote care for kids.”

For now, however, Brave Care is simply focused on providing the best possible care to patients in its Portland facility.

Brave Care is in the current Y Combinator class and has raised a total of $1.45 million in funding.

Serena Williams, Mark Cuban invest $3 million in Mahmee, a digital support network for new moms

Tennis superstar and mom to a 22-month-old, Serena Willams has joined Mark Cuban to invest $3 million seed funding in Mahmee, a startup working toward filling the critical care gap in postpartum care.

For those who’ve never given birth or who (count your blessings!) never had any mishaps in the hospital or afterwards, the weeks and months following childbirth can be extremely hard on the new mom, with estimates as high as one in five women suffering from postpartum depression or anxiety and about 9% of women experiencing post-traumatic-stress-disorder (PTSD) following childbirth — and those are just the mood and mental health disorders.

Physical recovery, even for those with a healthy, run-of-the-mill birth, takes at least six weeks. Eight weeks if you’ve had a C-section. And, then there are all the medical complications. Williams, who has a history of blood clots, ended up basically shouting at the doctors to give her a CT scan that saved her life.

The real issue, at the heart of all this, according to Mahmee co-founder Melissa Hanna, is that “the data is fragmented.” She says this is why she built a network to get new moms the support they need — from their community, other moms and medical providers.

Mahmee provides not only online group discussions with other moms going through the same thing and at the same stage but also connection to your medical provider. On top of that, it adds support from a trained “maternity coach” who can flag if something is wrong.

One example Hanna used was a new mom who was exhibiting symptoms of septic shock. The co-founder says a coach was able to call this mom on the spot and get her to contact her OB-GYN right away.

There are other online services like Postpartum Support International (PSI) and the Bloom Foundation, which both provide a sort of digital network and resources for new moms but Hanna believes it is that missing link to medical professionals after mom has gone home from the hospital that really make a difference.

“We’re so focused on delivering a healthy baby that mom gets side-lined,” She told TechCrunch. Adding in a statement, “And this industry is lacking the IT infrastructure needed to connect these professionals from different organizations to each other, and to follow and monitor patients across practices and health systems. This missing element creates gaps in care. Mahmee is the glue that connects the care ecosystem and closes the gaps.”

While other sites mentioned above are free to use, Mahmee, which goes beyond social support to providing engagement and patient monitoring, makes money through group and individual video calls (the introductory session with a coach is free) and various support groups. There are also different payment tiers starting at $20 a month and up towards $200 per month where new parents can ask unlimited questions through a HIPAA-secure, online dashboard connecting them with their medical providers and Mahmee coaches.

Do new moms need to pay someone to help them out and monitor them medically after they get home from the hospital? Possibly. Some local hospitals and medical networks also provide various types of help — both through counseling and new parent support groups. But often it can take weeks to get a counseling session at a busy hospital and your OB may have too many patients to call and check up on you. Having this type of support could just save your life — and, if anything else, checking in with a group of moms going through the same thing could be the key to saving your sanity.

Hanna admits it’s early days for her startup but tells TechCrunch there are over 1,000 providers in the Mahmee network so far. She plans to use the $3 million to grow her team out, including engineers, clinicians and sales staff and hints she’s working on several partnerships within the healthcare industry right now.

When someone great is gone: How to address grief in the workplace with empathy

Birthday cakes, gift cards, free lunches, snacks, movie tickets, and other perks are generously bestowed on employees to celebrate life’s happy moments. This is an improvement from the industrial approach to management, but can we go deeper for our work-family members?

Life’s darker moments hold the greatest opportunity to exemplify a genuine and caring 21st-century workplace culture. One which fosters empathy and camaraderie. Employee turnover is highest when employees take leave, claim FMLA, or use PTO. According to Global Studies, 79% of employees report their reason for quitting was simply due to feeling unnoticed (lack of appreciation).

Appreciation for your employees is best demonstrated as an act of kindness in moments that really matter, like the loss of a family member. Acknowledging that someone great is gone, instead of ignoring the uncomfortable aspects of grief, is a valuable way to embed empathy into your workplace culture.

Recently, while working with a mid-sized (500+ employees) tech company, I asked what they were doing to support employees during the negative life moments. The HR Director replied, “um, nothing really”.

Once realizing how crappy that sounded, another executive countered her by saying he sent an employee a t-shirt and card after a miscarriage. I later learned that the employee he was referring to had been with the company for over 5 years, so it’s safe to assume that she had a couple of company swag t-shirts in her collection prior to getting one as a get well gift.

Even in the largest and most notable companies, where a variety of employee amenities and benefits are offered, the concept and practice of empathy is often neglected. Perhaps you haven’t come across such extreme examples of indifference in your workplace, but you may have participated in signing a generic condolences card or chipping in for some flowers.

Kencko chugs down $3.4M to help you get more fruit and vegetables in your diet

Kencko, a company that wants to help people eat more fruit and vegetables in their daily life, is entering feast mode after it announced a $3.4 million seed round for growth and product development.

We profiled the company last year, but — for those who missed it — Kencko develops plant-based products that help people eat healthy without having to suffer the pain of horrible tasting food or other extreme eating. That’s to say that its fruit drinks, the company’s first product, include the pulp and vitamins absent in pressed juice but come in a convenient sachet that has been flash-frozen and slow-dried to retain all the goodness. The company says that each packet, which is 20g and mixes with water, contains two of the five-a-day recommendation for fruit and vegetable servings.

Right now, Kencko — which means health in Japanese — is selling the fruit drink with six different flavor options. Founder and CEO Tomás Froes said the plan is to add as many as half a dozen new options before this year is out. Also coming are two new products that, like the drinks, are made from 100% organic fruits and vegetables to, again, make it easy and tasty to eat healthily.

Beyond products, Kencko is also using the new capital to develop its direct-to-consumer strategy. A big focus of that is its mobile app which is currently in beta with early customers but will get a full launch this year, according to Froes.

Kencko products are sold in units but also as a subscription, and that bundle will include a personal nutritionist — from Kencko’s in-house team — who will use data collected in the app to help customers personalize their diet and approach to health. Further down the line, that may include face-to-face appointments in parts of the U.S. and remote-based sessions, added Froes — who runs the 25-person company with co-founder and CBD Ricardo Vice Santos.

Kencko is focused on the U.S. and Canada but it is available worldwide. Customers can buy the fruit drink through a $16 three-day-trial pack, or more committed packages of 20 and 60 sachets, which cost $60 and $150, respectively.

Froes became a vegan after being diagnosed with acute gastritis. He was inspired to start the company in 2017 after a 90% fruit and vegetable diet cleared the condition without medicine — a doctor had previously told him that he would need to be treated with a cocktail of pills for the rest of his life.

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Now, with plant-based brands like Impossible Foods and Beyond Meat booming and increased media coverage of the science and sustainability of food, Froes believes interest in healthy diet options has never been higher.

“There is demand for more transparency and knowledge on ingredients,” he explained in an interview. “The past few years have sparked a completely new revolution around food.”

The investment came from NextView Ventures, LocalGlobe, Kairos Ventures, Techstars, Max Ventures and other unnamed backers. Kencko took part in Techstar’s London accelerator last year.

Making wearables matter: Blood pressure monitoring could be the tipping point

Today’s wearables are still designed for the healthy and wealthy, not those who could benefit the most. Medical wearables offer the potential to collect health data and improve health via a combination of real-time AI and expert human intervention. Apple’s announcement of FDA clearance of its Watch for screening for irregular heart rhythms was meant to be groundbreaking. But its medical value right now remains limited and controversial. What will make the promise into reality?

I believe the application that will make wearables medically matter is automated blood pressure monitoring. Blood pressure may not be sexy, but it’s a universally understood measurement and a clinically central one. Your doctor measures your blood pressure every single time you visit. Even those who don’t pay close attention to their health know that high blood pressure increases risk of heart attack and stroke, and lower blood pressure saves lives.

High blood pressure, or hypertension, affects between 30-50% of adult Americans, or 75-120 million people. It’s the No. 1 risk factor in deaths worldwide, and the No. 1 modifiable risk in heart disease and stroke, the top two worldwide causes of death. Despite this, only half of people with high blood pressure are lowering it enough, even with medications. Why? A big reason is lack of information.

Doctors advise everyone at risk to monitor their blood pressure, but few do it often enough, in large part because inflatable blood pressure cuffs, while universal, are uncomfortable and inconvenient. In fact, current medical guidelines recommend automated blood pressure monitoring to more accurately measure your blood pressure, but hardly anyone is willing to use a motorized cuff that squeezes your arm every 30 minutes while you try to sleep! Cuffless automated monitoring would provide more accurate information, enable timely intervention, lower blood pressure and save lives.

Numerous companies have tried to create a cuffless automated blood pressure monitor, including Apple, Samsung, Google, Microsoft, Amazon, Fitbit and Jawbone, as well as a very long list of startups. No one has yet been successful. As a healthcare investor excited about this area, I have met with many of the startups working on this problem, and I see some common issues.

What’s missing?

Companies in this area should first focus on generating medical-quality data. Teams need experts in FDA regulation and clinical studies and need to listen to them when planning timelines and budgets. Unlike some other areas where VCs invest, this is not a market for moving fast and breaking things. Instead, companies need to collect training data from hundreds of people, especially those with hypertension, to ensure their product meets the FDA’s performance standards.

We can make wearables matter.

But accurate data is just the tip of the iceberg. More complete blood pressure data should enable healthier decisions and lower blood pressures. This could mean a warning that average blood pressure has increased recently, or a proactive text or call from your doctor or a family member. It could include suggested adjustments to medications or healthier behaviors based on patterns through the day and night. User experience plays a critical role in real-world use. Automated monitoring should be no more intrusive than wearing a wristwatch and getting a notification.

On the cusp

The good news is a breakthrough in this space doesn’t seem that far away. Better sensors, algorithms, computing power and battery life are helping companies produce results closer to FDA standards. I expect multiple groups will meet the challenge in the next 18 months. Room exists for multiple winners in this market, given the huge market opportunity and wide range of use cases. Every major wearable platform is under pressure to consider adding FDA-cleared applications, and blood pressure is at or near the top of their “most wanted” lists.

Companies that can connect better data to better blood pressure will be able to create value and win payment from insurers, consumers or both. For example, Medicare has recently significantly improved coverage of remote patient monitoring.

Measure what matters

Cuffless automated blood pressure monitoring will improve how we treat high blood pressure, both through medication and healthy behaviors. Automated monitoring will better support people at highest risk, such as patients recovering from heart failure or stroke, by providing early warnings of potential recurrence. Ultimately, we could even get early warnings of heart attacks, strokes or other events, giving us time to act.

Current wearables measure what comes easily, like steps and heart rate. By instead measuring what matters medically, we can use that data to extend lives. We can make wearables matter.

Cannabis processing startups hope to unlock new chemicals and treatments

Jeff Ubersax knows yeast.

The chief executive officer of Demetrix studied yeast genetics and biochemistry in school and was an early employee at Amyris Biotechnologies, a technology company that was using fermentation to make biofuels back in the early days of the first clean technology boom back in 2008. 

Now, the same technology that Ubersax and Jay Keasling, the celebrated professor from the University of California at Berkeley who co-founded Amyris and Demetrix, used to make biofuels is being applied to the production of cannabis.

The company launched with an $11 million seed round led by Horizons Ventures, a Hong Kong-based investment fund backed by the multi-billionaire real estate mogul Li Ka-shing, to begin commercializing the technology that Keasling had been researching in his lab.

The goal was to refine a process that would enable yeasts to make a range of cannabinoids that are found in the marijuana plant which could be used to develop new pharmaceuticals, additives and supplements for use in clinical and consumer applications. The technology works much the same way as brewing beer. Except instead of fermenting to produce alcohol, the fermentation process produces cannabinoids from genetically modified yeast cells.

While the technology holds promise, it’s still got a long way to go before it becomes competitive with extracts from the marijuana plant, but given new capital infusions the tide is turning.

Demetrix, for instance, has raised another $50 million from Horizons Ventures and Tuatara Capital, an investment firm focused on the legal cannabis industry, to significantly expand its production while simultaneously pursuing initial tests on the efficacy of rare strains of cannabinoids as treatments for certain illnesses.

“Natural cannabinoids have been used for a really long time,” says Ubersax. And last June the U.S. Food and Drug Administration approved the first pharmaceutical derived from cannabis, Epidiolex, as a treatment for patients with epilepsy.

Birth control delivery startup Nurx introduces STI home-testing kits

Nurx, the “Uber for birth control,” will allow customers to test themselves for many of the most common sexually transmitted infections within the comforts of their own homes with its new STI home-testing kits.

Nurx, a graduate of Y Combinator, has raised about $42 million in venture capital funding from Kleiner Perkins, Union Square Ventures, Lowercase Capital and others to date. It launched in 2015 to facilitate women’s access to birth control across the U.S. with a HIPAA-compliant web platform and mobile application that delivers contraceptives directly to customers’ doorsteps.

Its latest launch is its first since Rao replaced Hans Gangeskar, Nurx’s co-founder and CEO since 2014. Rao told TechCrunch in April that the startup realized they needed talent in the C-suite that had experienced fast growth.

In addition to selling birth control, Nurx provides PrEP, the once-daily pill that reduces the risk of getting HIV, and an HPV testing kit direct to consumer.

Nurx says they will facilitate in-person care for patients who test positive for an STI, if necessary, or will work closely with them to determine next steps including offering oral treatment. Costs for the tests will vary. Each will include a $12 consultation fee, which provides patients with unlimited access to Nurx’s medical team.

  • Full Control Kit: Gonorrhea & Chlamydia (Throat, Rectal, Urine), Syphilis, Hepatitis C & HIV will cost $75 with health insurance, $220 without health insurance.
  • Healthy Women’s Kit: Gonorrhea & Chlamydia (Throat, Vaginal), Trichomoniasis, Syphilis & HIV will cost $75 with health insurance, $190 without health insurance.
  • Covered with the Basics Kit: Gonorrhea & Chlamydia (Urine), Syphilis, HIV will cost $75 with health insurance, $160 without health insurance.

“Nurx is uniquely positioned to address the STI epidemic by breaking down barriers to testing and providing a convenient and affordable ‘all-in-one’ experience for our patients, from testing to guidance to treatment,” Rao said in a statement.

The company’s latest product launch follows a damning report from The New York Times in April that asserted Nurx, which delivers birth control and other medications directly to consumers, employed unorthodox and downright irresponsible business practices, including reshipping returned medications and attempting to revise medical policy.

Rao was announced as Nurx’s new chief executive officer only one week before the NYT report. After being accused of cutting corners, the company said the irresponsible practices highlighted in the story “were in place for a very limited time, impacted a very limited number of patients, and ended nearly a year ago.”

“The story’s depiction of Nurx does not reflect our policies now, but just as importantly, they do not accurately reflect the full picture of how we operated then,” Nurx wrote in a response to the story.

Doctours offers packaged medical tourism for U.S. customers

Doctours, a Los Angeles-based online platform for booking trips and treatments for medical and dental care around the world, is expanding its services to 35 countries.

Founded by serial travel entrepreneur Katelyn O’Shaughnessy, whose last company TripScope was acquired by Travefy, Doctours aims to connect patients with doctors to receive access to quality, affordable healthcare around the world.

The cost of care in the U.S. continues to climb, leading patients with few options but to travel to the best facilities offering the lowest cost care. Some companies that provide insurance benefits to their employees, like Walmart, are opting to pay for better care upfront by transporting their workers to facilities to receive appropriate care, rather than pay later for shoddy treatment.

Doctours sort of expands that thesis in an international context.

“When it comes to medical and dental treatment, there is no longer any reason to limit ourselves based on where we live,” said O’Shaughnessy, in a statement. “There is an increasingly advantageous global marketplace available with highly trained practitioners offering quality healthcare solutions at affordable prices and, although medical and dental tourism is a safe and cost-efficient solution, the current market is extremely fragmented and challenging to navigate. Doctours eliminates this fragmentation and allows anyone to easily and affordably access international medical and dental treatments and procedures.”

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Katelyn O’Shaughnessy, founder, Doctours

The company, which is backed by investors including investors in Doctours include the former CEO of Expedia, Erik Blachford, Texas billionaire and CEO of multi-strategy holding company, Cathexis, William Harrison, and Charles Cogliando of Mosaic Advisors, offers more than 330 different medical and dental procedures and has a global service area that includes Mexico, Colombia, the Caribbean, Thailand, Dubai, Brazil, Germany and Costa Rica. 

Currently working out of Quake Capital’s Austin incubator, the company helps patients search for and compare the cost of procedures, connect with doctors and book everything from in vitro fertilization to stem cell therapy, cosmetic and reparative plastic . surgery, weight loss surgery, dental work and Lasik. 

Once the procedure is booked, Doctours puts together itineraries that provide different options for flights and hotels based on the needs of the patient,  the company said.

The company also offers specialized medical tourism insurance to all of its customers, according to O’Shaughnessy. And the company vets its doctors by ensuring that they are Joint Commission International accredited physicians. Roughly 70% of the company’s doctors were trained at universities and medical schools in Europe or the U.S., O’Shaughnessy wrote in an email.

Doctours is certainly entering a lucrative market. Medical and dental tourism is a $439 billion global market growing at a rate of 25% per year, according to data provided by Doctours. In 2018 alone, 14 million patients traveled abroad to seek healthcare, according to the company.

Digital health is growing fast — but at what cost?

Silicon Valley is obsessed with growth. And for digital health startups, that obsession is not only misguided, but dangerous.

The prevailing idea in the tech industry is that to succeed, you have to be ready to sell your idea, no matter how far along your idea really is. You’re encouraged to believe in your product even when there is no product to believe in.

And if you’re disrupting the mattress industry or the eyewear sector, maybe that’s okay.

But digital health startups must be held to a different and higher standard. We touch people’s lives, often when they are at their most vulnerable.

The healthcare startups in the news recently — Theranos, uBiome, Nurx, eClinicalWorks, Practice Fusion — seem to have lost sight of that crucial standard. We’ll never know every detail of what happened in these organizations, but one thing seems clear: In the pursuit of growth, they have put the patient second, and suffered as a result.

Where we went wrong

In the early days of digital health, I think we were much more focused on the patient than we are now. When I think of the early digital health companies — not just Propeller, but Omada Health, WellDoc, Ginger.io and Mango Health — all of their founders had an innate understanding of the importance of health outcomes. They craved proof that their product worked. They might have “faked it” a little bit when it came to their plans to scale — we all thought things would happen faster than they have — but when it came to research, they had answers, or a concrete plan to get answers.

My first conversation with Propeller’s co-founder and CEO, David Van Sickle, was illustrative of this. I met David at the geekiest of health conferences, Health Datapalooza. We talked about how sensors on medicines could improve people’s health. We talked about study designs and methods to generate data quickly in the real world, long before “real-world evidence” was all the buzz. We talked about a 500-person randomized controlled trial they were about to begin, immediately following FDA clearance of the system.

We talked — almost exclusively — about how Propeller could improve people’s lives, and how to prove that it worked.

So when did the digital health sector get away from that focus? And how do we get back to it?

I have a few theories on what went wrong.

First, it’s incredibly difficult to prioritize the patient as a digital health company when your investors are pushing for growth above all else. At Propeller, we were very lucky to have investors who understood our focus on making a product that worked, especially when growth was slow. Early digital health companies were funded like tech companies, with small amounts of money at a time and a need to show significant progress in 18-24 months to get the next round of funding. In contrast, life science companies are funded more heavily from the start, knowing there is a long road ahead of product development and clinical validation.

When I look at a company like uBiome, which may have rushed its tests through physician approval to meet aggressive growth targets, I see the effects of a culture and funding environment that pushes companies to deliver on growth first and foremost, no matter the tactics it takes to do so.

Product, then proof, then commercialization.

Second, we had a flood of founders and investors enter digital health from outside of healthcare.

I think digital health absolutely needs people, ideas and energy from outside the industry in order to change healthcare. But we also need everyone to learn the basics of how innovation occurs in a clinical setting: Product, then proof, then commercialization. Many of these new entrants were not just naive; they flaunted laws and “traditional healthcare” methods (and people) because they were deemed outdated and unnecessary.

They were aiming for disruption, not integration, and in doing so were ignoring the vast set of protections and people that have been put in place to ensure public safety.

The result is a glut of companies that have tried to scale growth before proving their product worked, which comes with tremendous risk. It can give patients and their physicians incorrect information leading to incorrect treatment. It can waste money on unneeded products. And it can impact the credibility of the entire digital health ecosystem.

Rebuilding a culture of outcomes

To fix this, we have to change the way we think about success in digital health, and that responsibility falls on many different parties.

The media has to be more critical of how it covers burgeoning digital health startups, prioritizing coverage of peer-reviewed research and proven outcomes over funding rounds and hiring numbers. The speaking circuit has to laud founders who can talk about how their products have changed people’s lives for the better, rather than giving the main speaking slot to the biggest exit of the year. And the investor community has to be patient with its investments, understanding that true growth in healthcare takes time.

And most of all, digital health startup founders have to be patient with themselves. I’ve been in the trenches of digital health; I know how hard it can be. But when things are tough and it’s easy to lose focus, you have to think to yourself, “Do I want to be in the headlines for astonishing growth now, and accusations of cutting corners in two years? Or am I okay with sacrificing temporary stardom for a product that actually helps people?”

This is not an easy choice to make. But if digital health is going to survive and scale, it’s one we have to make on a daily basis. Move slowly, and prove things: It’s the only way to create the kind of long-term change we’re seeking.