RFID stickers could signal contaminated food

If a food item isn’t safe to eat, it’s best to find that out before someone eats it. But manual testing of every jar and bottle isn’t possible, even when a threat, like the recent baby food scare, is known. MIT researchers have found a way to check many items instantly, non-invasively and from a distance — using the RFID tags many products already have.

RFID, or radio frequency identification, uses a tiny antenna embedded in a sticker or label that’s activated and powered by radio waves at a very specific frequency. When a transceiver sends out a 950Mhz signal, the RFID tag wakes up and re-transmits a slightly different signal identifying itself. Products that announce themselves? Convenient for doing inventory!

What the researchers found was that this return signal, outside the actual information-bearing part, can be affected by the actual contents of the product, since the radio waves have to pass through them. Consequently, a jar full of pasta sauce and one full of olives would produce different signal profiles — as would an untouched jar of baby food compared with one contaminated with melamine.

“It’s almost as if we have transformed cheap RFIDs into tiny radio frequency spectroscopes,” said Fadel Adib, co-author of the paper describing the new system, in an MIT news release.

The problem is that these differences can be very minor and it’s not like they’ve been documented anywhere — this is the first time anyone’s tried this. So naturally, the team turned to machine learning. They trained up a model that can tell with confidence what a signal profile corresponds to, with the minor variations that come from, say, slight differences in orientation or glass width.

Right now the system, which they call RFIQ, can tell the difference between pure and melamine-contaminated baby formula, and between various adulterations of pure ethyl alcohol. That’s pretty much everything on my shopping list so I’m set, but obviously the team would like to have it apply to many more products. Now that the method has been shown to work, that’s the plan.

The task will only get harder, as things like environmental variables (shelves) and other wireless interference add to the problem. But machine learning algorithms are good at plucking signal out of the noise, so with luck the technique will work without too much trouble.

You can read the full paper documenting the RFIQ system here (PDF).

UK watchdog has eyes on Google-DeepMind’s health app hand-off

The shock news yesterday that Google is taking over a health app rolled out to UK hospitals over the past few years by its AI division, DeepMind, has caught the eye of the country’s data protection watchdog — which said today that it’s monitoring developments.

An ICO spokesperson told us: “An ICO investigation and an independent audit into the use of Google Deepmind’s Streams service by the Royal Free both highlighted the importance of clear and effective governance when NHS bodies use third parties to provide digital services, particularly to ensure the original purpose for processing personal data is respected.

“We expect all the measures set out in our undertaking, and in the audit, should remain in place even if the identity of the third party changes. We are continuing to monitor the situation.”

We’ve reached out to DeepMind and Google for a response.

The project is already well known to the ICO because, following a lengthy investigation, it ruled last year that the NHS Trust which partnered with DeepMind had broken UK law by passing 1.6 million+ patients’ medical records to the Google owned company during the app’s development.

The Trust agreed to make changes to how it works with DeepMind, with the ICO saying it needed to establish “a proper legal basis” for the data-sharing, as well as share more information about how it handles patients’ privacy.

It also had to submit to an external audit — which was carried out by Linklaters. Though — as we reported in June — this only looked at the current working of the Streams app.

The auditors did not address the core issue of patient data being passed without a legal basis when the app was under construction. And the ICO didn’t sound too happy about that either.

While regulatory actions kicked off in spring 2016, the sanctions came after Streams had already been rolled out to hospital wards — starting with the Royal Free NHS Trust’s own hospitals.

DeepMind also inked additional five-year Streams deals with a handful of other Trusts before the ICO’s intervention, including Imperial College Healthcare NHS Trust and Taunton & Somerset.

Those Trusts are now facing being switched to having Google as their third party app provider.

Until yesterday DeepMind had maintained it operates autonomously from Google, with founder Mustafa Suleyman writing in 2016 that: “We’ve been clear from the outset that at no stage will patient data ever be linked or associated with Google accounts, products or services.”

Two years on and, in their latest Medium blog, the DeepMind co-founders write about how excited they are that the data is going to Google.

Patients might have rather more mixed feelings, given that most people have never been consulted about any of this.

The lack of a legal basis for DeepMind obtaining patient data to develop Streams in the first place remains unresolved. And Google becoming the new data processor for Streams only raises fresh questions about information governance — and trust.

Meanwhile the ICO has not yet given a final view on Streams’ continued data processing — but it’s still watching.

Google gobbling DeepMind’s health app might be the trust shock we need

DeepMind’s health app being gobbled by parent Google is both unsurprising and deeply shocking.

First thoughts should not be allowed to gloss over what is really a gut punch.

It’s unsurprising because the AI galaxy brains at DeepMind always looked like unlikely candidates for the quotidian, margins-focused business of selling and scaling software as a service. The app in question, a clinical task management and alerts app called Streams, does not involve any AI.

The algorithm it uses was developed by the UK’s own National Health Service, a branch of which DeepMind partnered with to co-develop Streams.

In a blog post announcing the hand-off yesterday, “scaling” was the precise word the DeepMind founders chose to explain passing their baby to Google . And if you want to scale apps Google does have the well oiled machinery to do it.

At the same time Google has just hired Dr. David Feinberg, from US health service organization Geisinger, to a new leadership role which CNBC reports as being intended to tie together multiple, fragmented health initiatives and coordinate its moves into the $3TR healthcare sector.

The company’s stated mission of ‘organizing the world’s information and making it universally accessible and useful’ is now seemingly being applied to its own rather messy corporate structure — to try to capitalize on growing opportunities for selling software to clinicians.

That health tech opportunities are growing is clear.

In the UK, where Streams and DeepMind Health operates, the minister for health, Matt Hancock, a recent transplant to the portfolio from the digital brief, brought his love of apps with him — and almost immediately made technology one of his stated priorities for the NHS.

Last month he fleshed his thinking out further, publishing a future of healthcare policy document containing a vision for transforming how the NHS operates — to plug in what he called “healthtech” apps and services, to support tech-enabled “preventative, predictive and personalised care”.

Which really is a clarion call to software makers to clap fresh eyes on the sector.

In the UK the legwork that DeepMind has done on the ‘apps for clinicians’ front — finding a willing NHS Trust to partner with; getting access to patient data, with the Royal Free passing over the medical records of some 1.6 million people as Streams was being developed in the autumn of 2015; inking a bunch more Streams deals with other NHS Trusts — is now being folded right back into Google.

And this is where things get shocking.

Trust demolition

Shocking because DeepMind handing the app to Google — and therefore all the patient data that sits behind it — goes against explicit reassurances made by DeepMind’s founders that there was a firewall sitting between its health experiments and its ad tech parent, Google.

“In this work, we know that we’re held to the highest level of scrutiny,” wrote DeepMind co-founder Mustafa Suleyman in a blog post in July 2016 as controversy swirled over the scope and terms of the patient data-sharing arrangement it had inked with the Royal Free. “DeepMind operates autonomously from Google, and we’ve been clear from the outset that at no stage will patient data ever be linked or associated with Google accounts, products or services.”

As law and technology academic Julia Powles, who co-wrote a research paper on DeepMind’s health foray with the New Scientist journalist, Hal Hodson, who obtained and published the original (now defunct) patient data-sharing agreement, noted via Twitter: “This isn’t transparency, it’s trust demolition.”

Turns out DeepMind’s patient data firewall was nothing more than a verbal assurance — and two years later those words have been steamrollered by corporate reconfiguration, as Google and Alphabet elbow DeepMind’s team aside and prepare to latch onto a burgeoning new market opportunity.

Any fresh assurances that people’s sensitive medical records will never be used for ad targeting will now have to come direct from Google. And they’ll just be words too. So put that in your patient trust pipe and smoke it.

The Streams app data is also — to be clear — personal data that the individuals concerned never consented to being passed to DeepMind. Let alone to Google.

Patients weren’t asked for their consent nor even consulted by the Royal Free when it quietly inked a partnership with DeepMind three years ago. It was only months later that the initiative was even made public, although the full scope and terms only emerged thanks to investigative journalism.

Transparency was lacking from the start.

This is why, after a lengthy investigation, the UK’s data protection watchdog ruled last year that the Trust had breached UK law — saying people would not have reasonably expected their information to be used in such a way.

Nor should they. If you ended up in hospital with a broken leg you’d expect the hospital to have your data. But wouldn’t you be rather shocked to learn — shortly afterwards or indeed years and years later — that your medical records are now sitting on a Google server because Alphabet’s corporate leaders want to scale a fat healthtech profit?

In the same 2016 blog post, entitled “DeepMind Health: our commitment to the NHS”, Suleyman made a point of noting how it had asked “a group of respected public figures to act as Independent Reviewers, to examine our work and publish their findings”, further emphasizing: “We want to earn public trust for this work, and we don’t take that for granted.”

Fine words indeed. And the panel of independent reviewers that DeepMind assembled to act as an informal watchdog in patients’ and consumers’ interests did indeed contain well respected public figures, chaired by former Liberal Democrat MP Julian Huppert.

The panel was provided with a budget by DeepMind to carry out investigations of the reviewers’ choosing. It went on to produce two annual reports — flagging a number of issues of concern, including, most recently, warning that Google might be able to exert monopoly power as a result of the fact Streams is being contractually bundled with streaming and data access infrastructure.

The reviewers also worried whether DeepMind Health would be able to insulate itself from Alphabet’s influence and commercial priorities — urging DeepMind Health to “look at ways of entrenching its separation from Alphabet and DeepMind more robustly, so that it can have enduring force to the commitments it makes”.

It turns out that was a very prescient concern since Alphabet/Google has now essentially dissolved the bits of DeepMind that were sticking in its way.

Including — it seems — the entire external reviewer structure…

A DeepMind spokesperson told us that the panel’s governance structure was created for DeepMind Health “as a UK entity”, adding: “Now Streams is going to be part of a global effort this is unlikely to be the right structure in the future.”

It turns out — yet again — that tech industry DIY ‘guardrails’ and self-styled accountability are about as reliable as verbal assurances. Which is to say, not at all.

This is also both deeply unsurprisingly and horribly shocking. The shock is really that big tech keeps getting away with this.

None of the self-generated ‘trust and accountability’ structures that tech giants are now routinely popping up with entrepreneurial speed — to act as public curios and talking shops to draw questions away from what’s they’re actually doing as people’s data gets sucked up for commercial gain — can in fact be trusted.

They are a shiny distraction from due process. Or to put it more succinctly: It’s PR.

There is no accountability if rules are self-styled and therefore cannot be enforced because they can just get overwritten and goalposts moved at corporate will.

Nor can there be trust in any commercial arrangement unless it has adequately bounded — and legal — terms.

This stuff isn’t rocket science nor even medical science. So it’s quite the pantomime dance that DeepMind and Google have been merrily leading everyone on.

It’s almost as if they were trying to cause a massive distraction — by sicking up faux discussions of trust, fairness and privacy — to waste good people’s time while they got on with the lucrative business of mining everyone’s data.

Limiting social media use reduced loneliness and depression in new experiment

The idea that social media can be harmful to our mental and emotional well-being is not a new one, but little has been done by researchers to directly measure the effect; surveys and correlative studies are at best suggestive. A new experimental study out of Penn State, however, directly links more social media use to worse emotional states, and less use to better.

To be clear on the terminology here, a simple survey might ask people to self-report that using Instagram makes them feel bad. A correlative study would, for example, find that people who report more social media use are more likely to also experience depression. An experimental study compares the results from an experimental group with their behavior systematically modified, and a control group that’s allowed to do whatever they want.

This study, led by Melissa Hunt at Penn State’s psychology department, is the latter — which despite intense interest in this field and phenomenon is quite rare. The researchers only identified two other experimental studies, both of which only addressed Facebook use.

One hundred and forty-three students from the school were monitored for three weeks after being assigned to either limit their social media use to about 10 minutes per app (Facebook, Snapchat and Instagram) per day or continue using it as they normally would. They were monitored for a baseline before the experimental period and assessed weekly on a variety of standard tests for depression, social support and so on. Social media usage was monitored via the iOS battery use screen, which shows app use.

The results are clear. As the paper, published in the latest Journal of Social and Clinical Psychology, puts it:

The limited use group showed significant reductions in loneliness and depression over three weeks compared to the control group. Both groups showed significant decreases in anxiety and fear of missing out over baseline, suggesting a benefit of increased self-monitoring.

Our findings strongly suggest that limiting social media use to approximately 30 minutes per day may lead to significant improvement in well-being.

It’s not the final word in this, however. Some scores did not see improvement, such as self-esteem and social support. And later follow-ups to see if feelings reverted or habit changes were less than temporary were limited because most of the subjects couldn’t be compelled to return. (Psychology, often summarized as “the study of undergraduates,” relies on student volunteers who have no reason to take part except for course credit, and once that’s given, they’re out.)

That said, it’s a straightforward causal link between limiting social media use and improving some aspects of emotional and social health. The exact nature of the link, however, is something at which Hunt could only speculate:

Some of the existing literature on social media suggests there’s an enormous amount of social comparison that happens. When you look at other people’s lives, particularly on Instagram, it’s easy to conclude that everyone else’s life is cooler or better than yours.

When you’re not busy getting sucked into clickbait social media, you’re actually spending more time on things that are more likely to make you feel better about your life.

The researchers acknowledge the limited nature of their study and suggest numerous directions for colleagues in the field to take it from here. A more diverse population, for instance, or including more social media platforms. Longer experimental times and comprehensive follow-ups well after the experiment would help, as well.

The 30-minute limit was chosen as a conveniently measurable one, but the team does not intend to say that it is by any means the “correct” amount. Perhaps half or twice as much time would yield similar or even better results, they suggest: “It may be that there is an optimal level of use (similar to a dose response curve) that could be determined.”

Until then, we can use common sense, Hunt suggested: “In general, I would say, put your phone down and be with the people in your life.”

Hackers stole income, immigration and tax data in Healthcare.gov breach, government confirms

Hackers siphoned off thousands of Healthcare.gov applications by breaking into the accounts of brokers and agents tasked with helping customers sign up for healthcare plans.

The Centers for Medicare and Medicaid Services (CMS) said in a post buried on its website that the hackers obtained “inappropriate access” to a number of broker and agent accounts, which “engaged in excessive searching” of the government’s healthcare marketplace systems.

CMS didn’t say how the attackers gained access to the accounts, but said it shut off the affected accounts “immediately.”

In a letter sent to affected customers this week (and buried on the Healthcare.gov website), CMS disclosed that sensitive personal data — including partial Social Security numbers, immigration status and some tax information — may have been taken.

According to the letter, the data included:

  • Name, date of birth, address, sex, and the last four digits of the Social Security number (SSN), if SSN was provided on the application;
  • Other information provided on the application, including expected income, tax filing status, family relationships, whether the applicant is a citizen or an immigrant, immigration document types and numbers, employer name, whether the applicant was pregnant, and whether the applicant already had health insurance;
  • Information provided by other federal agencies and data sources to confirm the information provided on the application, and whether the Marketplace asked the applicant for documents or explanations;
  • The results of the application, including whether the applicant was eligible to enroll in a qualified health plan (QHP), and if eligible, the tax credit amount; and
  • If the applicant enrolled, the name of the insurance plan, the premium, and dates of coverage.

But the government said that no bank account information — including credit card numbers, or diagnostic and treatment information — was taken.

“Breaches that include personally identifiable information are always dangerous because they can lead to identity theft,” Andrew Blaich, head of Device Intelligence at Lookout. “Not only can the attacker steal the identity of anyone in the breach, but they can also use this information to appear credible when crafting mobile spear-phishing messages against their targets.”

“This is especially true if the data that was leaked is accurate, as health information, family relationships and insurance information can make it extremely easy for an attacker to steal the identity of anyone affected by the breach,” he said.

President Obama’s healthcare law, the Affordable Care Act — known as “Obamacare” — allows Americans to obtain health insurance if they are not already covered. In order to sign up for healthcare plans, customers have to submit sensitive data. Some 11.8 million people signed up for coverage for 2018.

CMS previously said that the breach affected 75,000 individuals, but a person familiar with the investigation said that the number is expected to change. The stolen files also included data on children.

A spokesperson said CMS is expected to give an update early next week at the latest.

Healthcare.gov’s enrollment period is set to close on December 15.

‘Grit’ author Angela Duckworth on working smart versus working too hard, when it’s okay to pivot, and the impact of tech on grit

Today, in San Francisco, at a gathering of roughly 400 women organized by the young AllRaise — a growing group of female funders and founders who aim to accelerate the success of their peers —  we sat down with Angela Duckworth. Ducksworth is a psychology professor at the University of Pennsylvania and has gained fame in recent years though a TED talk about grit that has now been viewed more than 15 million times, and a follow-up best-selling book titled Grit: The Power of Passion and Perseverance.

Duckworth’s biggest finding is that though success has many features, including raw intelligence and adaptability, the most crucial ingredient may be hard work over sustained periods of time, or grit. She also maintains that grit is not as fixed as are some other inherited traits, even while how gritty we are has a lot to do with our biology. In fact, Duckworth said at today’s event that she didn’t always think of herself as gritty.

“When I was growing up in a bedroom community in South Jersey, not practicing piano when I should have been, I had a father who would literally out of the blue say things like, ‘You know, you’re no genius.’ (After Duckworth was  awarded a MacArthur Genius Fellowship in 2013, she laughingly told attendees, she “got to show up at his apartment 40 years later and say, ‘Actually, I am, officially. Officially, I am a genius.'”)

Given the nature of the audience, Duckworth spent much of her on-stage time talking about how VCs and founders might evaluate potential prospects — not by IQ scores or gender of other widely accepted predictors of success — but instead by trying to gauge the passion and perseverance of the people who come into their orbits. She also shared some ideas on how to “cultivate” grit. Because founders and investors alike might find some of her insights useful, we’re publishing them here, edited lightly for length.

TC: You believe that grit is far from immutable. Did you think of  yourself as a gritty kid or did you become gritty once you figured out what you wanted to do with your life?

AD: I will say that if I look objectively at the data of my life, at what I was actually doing, that I absolutely evolved. My confidence increased, my leadership skills improved. I mean, I ran for some very low-level office in student government, like secretary publicity manager, and I couldn’t even land that as a high school student.

So I’ve evolved and increased in confidence. In particular, I have figured out what I want to do. It wasn’t until I was 32 and pregnant with my second child that I figured out I wanted to be a psychologist. I started my PhD at that age. So I’d say. There is absolutely compelling evidence in neuroscience that people change dramatically, they tend to evolve, our interests sharpen, our confidence generally improves. The story of human nature is the story of plasticity.

TC: You say that you gained confidence over the years. Is that because you found something that you are so good at or because you were getting validation elsewhere that made the pursuit of this thing — psychology in your case — more meaningful to you?

AD: It’s complicated. There are many things that make you who you are. But there are two striking factors. One is relationships. So when you look at people who are very successful or resilient, positive human outcomes come from extremely stable, strong, loving relationships. It is probably the most striking predictor of positive outcomes. It helps with everything: cardiovascular disease, how long you’re going to live, your income, your wealth. Everything comes downs to having somebody who loves you. And though I did have an imperfect father, as many of us in this room did, I did feel loved. And at different points in my life, I felt cared for by other people who were not my parents, and it is really very important, including by the way, when you’re looking at building a company. I think that has to be part of the culture.

TC: Meaning a culture of professional development.

AD: Yes. If you don’t want to call it love, because that’s too cheesy, call it something else. But it needs to feature extremely positive social support. And long-term relationships need to be easy to create in that company, not difficult.

I think another secret to confidence is being able to point to small wins. Human confidence does not just come from pep talks with role models. There have to be small wins, even if they aren’t obvious wins. And if you want to cultivate successful entrepreneurs, there has to be a structure where they have smaller goals and enjoy victories over those goals.

TC: Presumably, most of the women in this audience, like you, have no shortage of grit or they probably would not be here. What I wonder about is when grit veers into workaholism. When is one working too hard?

AD: Yeah. The message of “Grit” is not that 90-hour workweeks [are ideal] or all-nighters because the emphasis on endurance suggests that you have to take care of yourself. I mean, if it were a 60-second sprint [that you were facing], I guess you could do all these unhealthy things. But it is a long-term goal that you’re working on, and therefore it’s incredibly important, the way you pick the way you want to do it. You have to care for yourself physically and emotionally to stay in the game.

Even Olympic athletes at the peak of their careers are doing probably four hours at most, pre-Olympics, of actual deliberate practice. So again, it should not be about sheer quantity but rather high-quality work and a sustainable routine.

TC:  In addition to maybe working long versus working smart, I associate workaholism with needing or doing something for outside, versus internal, validation. Is that inaccurate?

AD: Data on this is also incredibly intuitive. Really successful entrepreneurs have enormous internal motivation. They aren’t waking up to do work because they ought to; they’re waking up because they want to [wake up and do their work].

TC: There’s a lot in your teachings about grit about stick-to-it-ive-ness. But in Silicon Valley, founders are known for pivoting when things aren’t working. When should people get credit for cutting their losses and moving on?

AD: I’ll give you my parenting advice for those of you with a kid in your life, because I think it’s also reasonably good VC advice.

In my family, everybody has a “hard thing” rule.  Everyone has to pick a hard thing. It’s not “tiger” parenting. But you have to do something that requires deliberate practice, something that requires a cycle [wherein you’re] breaking things down into skills and then sub skills and really concentrating and getting feedback and doing it again.

Our second thing is that you can’t quit in the middle of something.

As a parent, I thought this was a way to teach work ethic, and teach our kids how to practice because that’s not something you are born knowing how to do. We wanted them to have some kind of bias to follow through on their commitments. It’s not a bad rule, I would imagine, for investing, too, or running a company. You want to help the people in your portfolio or the people in your company do things that are hard, to follow through on their commitments to their natural end while also making sure that that if you going to [stop this thing that you doing], that you decide it on a good day.

We all have a fight-or-flight system that gets activated on bad days, and it is generally not a good idea to use the front part of your brain if that has happened because these things are in conflict. But if on a really good day, after you’ve had your cup of coffee and you look and you’re like, I really don’t want to do this anymore, then that’s probably a rational decision.

TC: At Penn, you continue to study evidence-based ways to build character in kids. What can you tell this audience about tech’s impact on grit, for both children and adults?

AD: I’ve done a little bit of research on tech, but I can also summarize some of the research on social media in particular, and tech in general, and kids are for spending an unbelievable amount of time [with tech]. It’s about as much time as they are in school — an equal number of hours.

When you look at longitudinal data to see what happens when people spend more time on social media, what happens in general is that people get more depressed and unhappy. It’s through his mechanism of comparison to others and envy. You know, there’s always a sunset and everyone looks beautiful and you then think that you look like shit and you’re boring.

That’s the bad news. Here’s the good news. The sword cuts the other way as well. In many studies, when you use social media in an active way as opposed to passive way, so not scrolling through everybody’s pictures but communicating with other people and messaging your friends or even posting pictures of your own, it increases your feelings of social connection and well-being. So the sword is right now positioned the wrong way, against well-being and happiness and security, but it can cut the other way. And because tech isn’t going away, I think it’s the responsibility of this community to figure out how to make that happen.

Naya Health, once a promising breast pump startup, now leaving customers in the dark

With their loud noises and hard plastic flanges, breast pumps are the bane of many a new mother’s existence. Founded in 2013, Naya Health is one of the most notable tech startups working on a better pump. But the company’s support site is now shutdown and it’s stopped updating its social media accounts. In a report today, CNBC spoke to several customers who said their pumps, which cost $1,000 and aren’t covered by insurance, had stopped working, and Naya Health had not provided them with adequate support or replacement parts.

Several users have also complained on Naya Health’s Facebook page about non-delivery of pumps they ordered months ago. A Kickstarter campaign created for Naya Health’s smart baby bottle, which raised more than $100,000, is also filled with complaints about orders not being fulfilled (the last response from co-founder and CEO Janica Alvarez was posted six months ago).

Naya Health’s Facebook and Instagram accounts haven’t been updated since summer, even though users are still posting complaints, while its Twitter account has been set to protected mode. An email sent to Alvarez, who co-founded the company with her husband Jeffery Alvarez, Naya Health’s CTO, received an auto-reply. TechCrunch has also contacted Naya Health investors Tandem Capital and Bojiang Capital, the co-leads of its seed round, for comment. The company has raised $4.6 million in angel and seed funding, according to Crunchbase.

While the Naya Health breast pump’s price tag is significantly more than most competing devices, customers were willing to give it a chance because of its unique flange design, which used silicone and water instead of plastic cups to recreate a nursing baby’s mouth.

iPharmacy Roman fights stigmas with premature ejaculation meds

There’s a war brewing to become the cloud pharmacy for men’s health. Roman, which launched last year offering erectile dysfunctional medication and recently added a ‘quit smoking’ kit, is taking on $97 million-funded Hims for the hair loss market. Today, Roman launched four new products it hopes to cross-sell to users through a unified telemedicine subscription and pill delivery app. It now sells meds for premature ejaculation, oral herpes, genital herpes, and hair loss at what’s often a deep discount versus your local drug store. And for those who are too far gone, it’s launching a “Bald Is Beautiful, Too” microsite for finding the best razors, lotions, and head shaving tips.

Roman CEO Zachariah Reitano

“It’s unlikely that you’ll buy razors from Bonobos or pants from Dollar Shave Club. But with a doctor, it’s actually the exact opposite” Roman CEO Zachariah Reitano tells me. “As a customer you’re frustrated if they send you somewhere else.” And so what started as a single product startup is blossoming into a powerful product mix that can keep users loyal.

Roman starts with a telemedicine doctor’s visit where patients can talk about their health troubles without the embarrassment of going to their general practitioner. When appropriate, the doc can then prescribe medications customers can then instantly buy through Roman.

“If you have something that’s truly consuming your day-to-day, it makes it really hard or nearly impossible to think about the long-term. If you’re 30 pounds overweight and experiencing erectile dysfunction, [it’s the latter symptom] that’s dominating your head space” Reitano explains. The doctor might focus on the underlying health issue, but most humans aren’t so logical, and want the urgent issue fixed first. Reitano’s theory is that if it can treat someone’s erectile dysfunction or hair loss first, they’ll have the resolve to tackle bigger lifelong health challenges. “We’re hoping to work on this so you can take a deep breath and get the monkey off your back” the CEO tells me.

But one thing Roman won’t do is prescribe homeopathic remedies or spurious remedies. “We will only ever offer products that are backed by science and proven to work” Reitano declares. Taking a shot at Roman’s competitor, he says “Hims sells gummies. Roman does not.  No doctor would say Biotin would help you regrow hair”, plus the vitamin can distort blood pressure readings that make it tough to tell if someone is having a heart attack.

“Roman will never slap sugar on vitamins, sell them on Snapchat, and say they’ll regrow your hair” Reitano jabs. Roman also benefits from the fact that Reitano’s father and one of the company’s advisors Dr. Michael Reitano was a lead author on a groundbreaking study about how Valacyclovir could be used to suppress transmission of genital herpes.

So what is Roman selling?

With Roman, Hims, Amazon acquisition PillPack, and more, there’s a powerful trend in direct-to-consumer medication emerging. Reitano sees it as the outcome of five intersecting facts.

  1. The evolution of telemedicine regulation allowing physicians to have a national presence by seeing patients online
  2. Physicians are being reimbursed less by Medicare, Medicaid, and private insurers for the same activity, pushing them towards telemedicine
  3. A patent cliff is making many medications suddenly affordable under generic names.
  4. Insurance deductibles are increasing, turning patients into consumers
  5. Technology is making it easier and cheaper to start medical startups

Roman’s $88 million Series A it announced last month is proof of this growing trend. Investors see the traditional pharmacy structure as highly vulnerable to disruption.

Roman will have defeat not just security threats and competitors, but also the status quo of keeping a stiff upper lip. A lot of men silently suffer these conditions rather than speak up. By speaking candidly about his own erectile dysfunction as a side-effect of heart medication, Reitano is trying to break the stigma and get more patients seeking help wherever feels right to them.

China is funding the future of American biotech

Silicon Valley is in the midst of a health craze, and it is being driven by “Eastern” medicine.

It’s been a record year for US medical investing, but investors in Beijing and Shanghai are now increasingly leading the largest deals for US life science and biotech companies. In fact, Chinese venture firms have invested more this year into life science and biotech in the US than they have back home, providing financing for over 300 US-based companies, per Pitchbook. That’s the story at Viela Bio, a Maryland-based company exploring treatments for inflammation and autoimmune diseases, which raised a $250 million Series A led by three Chinese firms.

Chinese capital’s newfound appetite also flows into the mainland. Business is booming for Chinese medical startups, who are also seeing the strongest year of venture investment ever, with over one hundred companies receiving $4 billion in investment.

As Chinese investors continue to shift their strategies towards life science and biotech, China is emphatically positioning itself to be a leader in medical investing with a growing influence on the world’s future major health institutions.

Chinese VCs seek healthy returns

We like to talk about things we can interact with or be entertained by. And so as nine-figure checks flow in and out of China with stunning regularity, we fixate on the internet giants, the gaming leaders or the latest media platform backed by Tencent or Alibaba.

However, if we follow the money, it’s clear that the top venture firms in China have actually been turning their focus towards the country’s deficient health system.

A clear leader in China’s strategy shift has been Sequoia Capital China, one of the country’s most heralded venture firms tied to multiple billion-dollar IPOs just this year.

Historically, Sequoia didn’t have much interest in the medical sector.  Health was one of the firm’s smallest investment categories, and it participated in only three health-related deals from 2015-16, making up just 4% of its total investing activity. 

Recently, however, life sciences have piqued Sequoia’s fascination, confirms a spokesperson with the firm.  Sequoia dove into six health-related deals in 2017 and has already participated in 14 in 2018 so far.  The firm now sits among the most active health investors in China and the medical sector has become its second biggest investment area, with life science and biotech companies accounting for nearly 30% of its investing activity in recent years.

Health-related investment data for 2015-18 compiled from Pitchbook, Crunchbase, and SEC Edgar

There’s no shortage of areas in need of transformation within Chinese medical care, and a wide range of strategies are being employed by China’s VCs. While some investors hope to address influenza, others are focused on innovative treatments for hypertension, diabetes and other chronic diseases.

For instance, according to the Chinese Journal of Cancer, in 2015, 36% of world’s lung cancer diagnoses came from China, yet the country’s cancer survival rate was 17% below the global average. Sequoia has set its sights on tackling China’s high rate of cancer and its low survival rate, with roughly 70% of its deals in the past two years focusing on cancer detection and treatment.

That is driven in part by investments like the firm’s $90 million Series A investment into Shanghai-based JW Therapeutics, a company developing innovative immunotherapy cancer treatments. The company is a quintessential example of how Chinese VCs are building the country’s next set of health startups using their international footprints and learnings from across the globe.

Founded as a joint-venture offshoot between US-based Juno Therapeutics and China’s WuXi AppTec, JW benefits from Juno’s experience as a top developer of cancer immunotherapy drugs, as well as WuXi’s expertise as one of the world’s leading contract research organizations, focusing on all aspects of the drug R&D and development cycle.

Specifically, JW is focused on the next-generation of cell-based immunotherapy cancer treatments using chimeric antigen receptor T-cell (CAR-T) technologies. (Yeah…I know…) For the WebMD warriors and the rest of us with a medical background that stopped at tenth-grade chemistry, CAR-T essentially looks to attack cancer cells by utilizing the body’s own immune system.

Past waves of biotech startups often focused on other immunologic treatments that used genetically-modified antibodies created in animals.  The antibodies would effectively act as “police,” identifying and attaching to “bad guy” targets in order to turn off or quiet down malignant cells.  CAR-T looks instead to modify the body’s native immune cells to attack and kill the bad guys directly.

Chinese VCs are investing in a wide range of innovative life science and biotech startups. (Photo by Eugeneonline via Getty Images)

The international and interdisciplinary pedigree of China’s new medical leaders not only applies to the organizations themselves but also to those running the show.

At the helm of JW sits James Li.  In a past life, the co-founder and CEO held stints as an executive heading up operations in China for the world’s biggest biopharmaceutical companies including Amgen and Merck.  Li was also once a partner at the Silicon Valley brand-name investor, Kleiner Perkins.

JW embodies the benefits that can come from importing insights and expertise, a practice that will come to define the companies leading the medical future as the country’s smartest capital increasingly finds its way overseas.

GV and Founders Fund look to keep the Valley competitive

Despite heavy investment by China’s leading VCs, Silicon Valley is doubling down in the US health sector.  (AFP PHOTO / POOL / JASON LEE)

Innovation in medicine transcends borders. Sickness and death are unfortunately universal, and groundbreaking discoveries in one country can save lives in the rest.

The boom in China’s life science industry has left valuations lofty and cross-border investment and import regulations in China have improved.

As such, Chinese venture firms are now increasingly searching for innovation abroad, looking to capitalize on expanding opportunities in the more mature US medical industry that can offer innovative technologies and advanced processes that can be brought back to the East.

In April, Qiming Venture Partners, another Chinese venture titan, closed a $120 million fund focused on early-stage US healthcare. Qiming has been ramping up its participation in the medical space, investing in 24 companies over the 2017-18 period.

New firms diving into the space hasn’t frightened the Bay Area’s notable investors, who have doubled down in the US medical space alongside their Chinese counterparts.

Partner directories for America’s most influential firms are increasingly populated with former doctors and medically-versed VCs who can find the best medical startups and have a growing influence on the flow of venture dollars in the US.

At the top of the list is Krishna Yeshwant, the GV (formerly Google Ventures) general partner leading the firm’s aggressive push into the medical industry.

Krishna Yeshwant (GV) at TechCrunch Disrupt NY 2017

A doctor by trade, Yeshwant’s interest runs the gamut of the medical spectrum, leading investments focusing on anything from real-time patient care insights to antibody and therapeutic technologies for cancer and neurodegenerative disorders.

Per data from Pitchbook and Crunchbase, Krishna has been GV’s most active partner over the past two years, participating in deals that total over a billion dollars in aggregate funding.

Backed by the efforts of Yeshwant and select others, the medical industry has become one of the most prominent investment areas for Google’s venture capital arm, driving roughly 30% of its investments in 2017 compared to just under 15% in 2015.

GV’s affinity for medical-investing has found renewed life, but life science is also part of the firm’s DNA.  Like many brand-name Valley investors, GV founder Bill Maris has long held a passion for the health startups.  After leaving GV in 2016, Maris launched his own fund, Section 32, focused specifically on biotech, healthcare and life sciences. 

In the same vein, life science and health investing has been part of the lifeblood for some major US funds including Founders Fund, which has consistently dedicated over 25% of its deployed capital to the space since at least 2015.

The tides may be changing, however, as the recent expansion of oversight for the Committee on Foreign Investment in the United States (CFIUS) may severely impact the flow of Chinese capital into areas of the US health sector. 

Under its extended purview, CFIUS will review – and possibly block – any investment or transaction involving a foreign entity related to the production, design or testing of technology that falls under a list of 27 critical industries, including biotech research and development.

The true implications of the expanded rules will depend on how aggressively and how often CFIUS exercises its power.  But a lengthy review process and the threat of regulatory blocks may significantly increase the burden on Chinese investors, effectively shutting off the Chinese money spigot.

Regardless of CFIUS, while China’s active presence in the US health markets hasn’t deterred Valley mainstays, with a severely broken health system and an improved investment environment backed by government support, China’s commitment to medical innovation is only getting stronger.

VCs target a disastrous health system

Deficiencies in China’s health sector has historically led to troublesome outcomes.  Now the government is jump-starting investment through supportive policy. (Photo by Alexander Tessmer / EyeEm via Getty Images)

They say successful startups identify real problems that need solving. Marred with inefficiencies, poor results, and compounding consumer frustration, China’s health industry has many

Outside of a wealthy few, citizens are forced to make often lengthy treks to overcrowded and understaffed hospitals in urban centers.  Reception areas exist only in concept, as any open space is quickly filled by hordes of the concerned, sick, and fearful settling in for wait times that can last multiple days. 

If and when patients are finally seen, they are frequently met by overworked or inexperienced medical staff, rushing to get people in and out in hopes of servicing the endless line behind them. 

Historically, when patients were diagnosed, treatment options were limited and ineffective, as import laws and affordability issues made many globally approved drugs unavailable.

As one would assume, poor detection and treatment have led to problematic outcomes. Heart disease, stroke, diabetes and chronic lung disease accounts for 80% of deaths in China, according to a recent report from the World Bank

Recurring issues of misconduct, deception and dishonesty have amplified the population’s mounting frustration.

After past cases of widespread sickness caused by improperly handled vaccinations, China’s vaccine crisis reached a breaking point earlier this year.  It was revealed that 250,000 children had been given defective and fallacious rabies vaccinations, a fact that inspectors had discovered months prior and swept under the rug.

Fracturing public trust around medical treatment has serious, potentially destabilizing effects. And with deficiencies permeating nearly all aspects of China’s health and medical infrastructure, there is a gaping set of opportunities for disruptive change.

In response to these issues, China’s government placed more emphasis on the search for medical innovation by rolling out policies that improve the chances of success for health startups, while reducing costs and risk for investors.

Billions of public investment flooded into the life science sector, and easier approval processes for patents, research grants, and generic drugs, suddenly made the prospect of building a life science or biotech company in China less daunting. 

For Chinese venture capitalists, on top of financial incentives and a higher-growth local medical sector, loosening of drug import laws opened up opportunities to improve China’s medical system through innovation abroad.

Liquidity has also improved due to swelling global interest in healthcare. Plus, the Hong Kong Stock Exchange recently announced changes to allow the listing of pre-revenue biotech companies.

The changes implemented across China’s major institutions have effectively provided Chinese health investors with a much broader opportunity set, faster growth companies, faster liquidity, and increased certainty, all at lower cost.

However, while the structural and regulatory changes in China’s healthcare system has led to more medical startups with more growth, it hasn’t necessarily driven quality.

US and Western investors haven’t taken the same cross-border approach as their peers in Beijing. From talking with those in the industry, the laxity of the Chinese system, and others, have made many US investors weary of investing in life science companies overseas.

And with the Valley similarly stepping up its focus on startups that sprout from the strong American university system, bubbling valuations have started to raise concern.

But with China dedicating more and more billions across the globe, the country is determined to patch the massive holes in its medical system and establish itself as the next leader in international health innovation.

Hackers breach Healthcare.gov system, taking files on 75,000 people

A government system used by insurance agents and brokers to help customers sign up for healthcare plans was breached, allowing hackers to siphon off sensitive and personal data on 75,000 people.

The Centers for Medicare and Medicaid Services confirmed the breach in a late Friday announcement, but revealed few details about the contents of the files stolen.

The hacked system was connected to the Healthcare.gov website, the front-facing portal for anyone signing up for an insurance plan under former President Obama’s healthcare law, the Affordable Care Act. Hackers targeted the behind-the-scenes system that insurance agents used to help customers directly enroll in new plans, and not the consumer Healthcare.gov site itself. 

In order to sign up for healthcare plans, customers have to give over a ton of personal data — including names, addresses, and their social security number. CMS didn’t say exactly what kind of data was included in the stolen files, nor did it say how the breach happened.

Spokesperson Jonathan Monroe didn’t respond to a request for comment.

CMS said that the Healthcare.gov website was unaffected. Open enrollment in new healthcare plans — set for November 1 — will be unaffected, the statement said. Officials are “working to identify the individuals potentially impacted as quickly as possible so that we can notify them and provide resources such as credit protection.”