Meet Utah’s next unicorn

Weave, a developer of patient communications software focused on the dental and optometry market, was the first Utah-headquartered company to graduate from Y Combinator in 2014. Now, it’s poised to enter a small but growing class startups in the ‘Silicon Slopes’ to garner ‘unicorn’ status.

The business announced a $70 million Series D last week at a valuation of $970 million. Tiger Global Management led the round, with participation from existing backers Catalyst Investors, Bessemer Venture Partners, Crosslink Capital, Pelion Venture Partners and LeadEdge Capital.

The company was founded in 2011 and fully bootstrapped until enrolling in the Silicon Valley accelerator program five years ago. Since then, it’s raised a total of $156 million in private funding, tripling its valuation with the latest infusion of capital.

Weave

“Our aim with this funding round is to exceed our customers’ expectations at every touchpoint, investing heavily in the products we create, the markets we serve and the overall customer experience we provide,” Weave co-founder and chief executive officer Brandon Rodman said in a statement. “We will continue to invest in our customers, our products and our people to build a solid, sustainable, and scalable business.”

Weave charges its customers, small and medium-sized businesses, upwards of $500 per month for access to its Voice Over IP-based unified communications service. Rodman previously launched a scheduling service for dentists and realized the opportunity to integrate texting, phone service, fax and reviews to facilitate the patient-provider relationship.

While his second effort, Weave, has long been targeting the dentistry and optometry market, Rodman told Venture Beat last year the opportunities for the company are endless: “Ultimately, if a business needs to communicate with their customer, we see that as a possible future customer of Weave.”

Based in Lehi, Weave added 250 employees this year with total headcount now reaching 550. The company claims to have doubled its revenue in 2018, too. While we don’t have any real insight into its financials, given the interest it’s garnered amongst Bay Area investors, we’re guessings it’s posting some pretty attractive numbers.

“Weave has some of the best retention numbers we’ve ever seen for an SMB SaaS company,” Catalyst partner Tyler Newton said in a statement. “We’re continually impressed by their accelerated growth and results.”

Alexa, where are the legal limits on what Amazon can do with my health data?

The contract between the UK’s National Health Service (NHS) and ecommerce giant Amazon — for a health information licensing partnership involving its Alexa voice AI — has been released following a Freedom of Information request.

The government announced the partnership this summer. But the date on the contract, which was published on the gov.uk contracts finder site months after the FOI was filed, shows the open-ended arrangement to funnel nipped-and-tucked health advice from the NHS’ website to Alexa users in audio form was inked back in December 2018.

The contract is between the UK government and Amazon US (Amazon Digital Services, Delaware) — rather than Amazon UK. 

Nor is it a standard NHS Choices content syndication contract. A spokeswoman for the Department of Health and Social Care (DHSC) confirmed the legal agreement uses an Amazon contract template. She told us the department had worked jointly with Amazon to adapt the template to fit the intended use — i.e. access to publicly funded healthcare information from the NHS’ website.

The NHS does make the same information freely available on its website, of course. As well as via API — to some 1,500 organizations. But Amazon is not just any organization; It’s a powerful US platform giant with a massive ecommerce business.

The contract reflects that power imbalance; not being a standard NHS content syndication agreement — but rather DHSC tweaking Amazon’s standard terms.

“It was drawn up between both Amazon UK and the Department for Health and Social Care,” a department spokeswoman told us. “Given that Amazon is in the business of holding standard agreements with content providers they provided the template that was used as the starting point for the discussions but it was drawn up in negotiation with the Department for Health and Social Care, and obviously it was altered to apply to UK law rather than US law.”

In July, when the government officially announced the Alexa-NHS partnership, its PR provided a few sample queries of how Amazon’s voice AI might respond to what it dubbed “NHS-verified” information — such as: “Alexa, how do I treat a migraine?”; “Alexa, what are the symptoms of flu?”; “Alexa, what are the symptoms of chickenpox?”.

But of course as anyone who’s ever googled a health symptom could tell you, the types of stuff people are actually likely to ask Alexa — once they realize they can treat it as an NHS-verified info-dispensing robot, and go down the symptom-querying rabbit hole — is likely to range very far beyond the common cold.

At the official launch of what the government couched as a ‘collaboration’ with Amazon, it explained its decision to allow NHS content to be freely piped through Alexa by suggesting that voice technology has “the potential to reduce the pressure on the NHS and GPs by providing information for common illnesses”.

Its PR cited an unattributed claim that “by 2020, half of all searches are expected to be made through voice-assisted technology”.

This prediction is frequently attributed to ComScore, a media measurement firm that was last month charged with fraud by the SEC. However it actually appears to originate with computer scientist Andrew Ng, from when he was chief scientist at Chinese tech giant Baidu.

Econsultancy noted last year that Mary Meeker included Ng’s claim on a slide in her 2016 Internet Trends report — which is likely how the prediction got so widely amplified.

But on Meeker’s slide you can see that the prediction is in fact “images or speech”, not voice alone…

Screenshot 2019 10 24 at 10.04.40

So it turns out the UK government incorrectly cited a tech giant prediction to push a claim that “voice search has been increasing rapidly” — in turn its justification for funnelling NHS users towards Amazon.

“We want to empower every patient to take better control of their healthcare and technology like this is a great example of how people can access reliable, world-leading NHS advice from the comfort of their home, reducing the pressure on our hardworking GPs and pharmacists,” said health secretary Matt Hancock in a July statement.

Since landing at the health department, the app-loving former digital minister has been pushing a tech-first agenda for transforming the NHS — promising to plug in “healthtech” apps and services, and touting “preventative, predictive and personalised care”. He’s also announced an AI lab housed within a new unit that’s intended to oversee the digitization of the NHS.

Compared with all that, plugging the NHS’ website into Alexa probably seems like an easy ‘on-message’ win. But immediately the collaboration was announced concerns were raised that the government is recklessly mixing the streams of critical (and sensitive) national healthcare infrastructure with the rapacious data-appetite of a foreign tech giant with both an advertising and ecommerce business, plus major ambitions of its own in the healthcare space.

On the latter front, just yesterday news broke of Amazon’s second health-related acquisition: Health Navigator, a startup with an API platform for integrating with health services, such as telemedicine and medical call centers, which offers natural language processing tools for documenting health complaints and care recommendations.

Last year Amazon also picked up online pharmacy PillPack — for just under $1BN. While last month it launched a pilot of a healthcare service offering to its own employees in and around Seattle, called Amazon Care. That looks intended to be a road-test for addressing the broader U.S. market down the line. So the company’s commercial designs on healthcare are becoming increasingly clear.

Returning to the UK, in response to early critical feedback on the Alexa-NHS arrangement, the IT delivery arm of the service, NHS Digital, published a blog post going into more detail about the arrangement — following what it couched as “interesting discussion about the challenges for the NHS of working with large commercial organisations like Amazon”.

A core critical “discussion” point is the question of what Amazon will do with people’s medical voice query data, given the partnership is clearly encouraging people to get used to asking Alexa for health advice.

“We have stuck to the fundamental principle of not agreeing a way of working with Amazon that we would not be willing to consider with any single partner – large or small. We have been careful about data, commercialisation, privacy and liability, and we have spent months working with knowledgeable colleagues to get it right,” NHS Digital claimed in July.

In another section of the blog post, responding to questions about what Amazon will do with the data and “what about privacy”, it further asserted there would be no health profiling of customers — writing:

We have worked with the Amazon team to ensure that we can be totally confident that Amazon is not sharing any of this information with third parties. Amazon has been very clear that it is not selling products or making product recommendations based on this health information, nor is it building a health profile on customers. All information is treated with high confidentiality. Amazon restrict access through multi-factor authentication, services are all encrypted, and regular audits run on their control environment to protect it.

Yet it turns out the contract DHSC signed with Amazon is just a content licensing agreement. There are no terms contained in it concerning what can or can’t be done with the medical voice query data Alexa is collecting with the help of “NHS-verified” information.

Per the contract terms, Amazon is required to attribute content to the NHS when Alexa responds to a query with information from the service’s website. (Though the company says Alexa also makes use of medical content from the Mayo Clinic and Wikipedia.) So, from the user’s point of view, they will at times feel like they’re talking to an NHS-branded service.

But without any legally binding confidentiality clauses around what can be done with their medical voice queries it’s not clear how NHS Digital can confidently assert that Amazon isn’t creating health profiles.

The situation seems to sum to, er, trust Amazon. (NHS Digital wouldn’t comment; saying it’s only responsible for delivery not policy setting, and referring us to the DHSC.)

Asked what it does with medical voice query data generated as a result of the NHS collaboration an Amazon spokesperson told us: “We do not build customer health profiles based on interactions with nhs.uk content or use such requests for marketing purposes.”

But the spokesperson could not point to any legally binding contract clauses in the licensing agreement that restrict what Amazon can do with people’s medical queries.

We’ve also asked the company to confirm whether medical voice queries that return NHS content are being processed in the US.

“This collaboration only provides content already available on the NHS.UK website, and absolutely no personal data is being shared by NHS to Amazon or vice versa,” Amazon also told us, eliding the key point that it’s not NHS data being shared with Amazon but NHS users, reassured by the presence of a trusted public brand, being encouraged to feed Alexa sensitive personal data by asking about their ailments and health concerns.

Bizarrely, the Department of Health and Social Care went further. Its spokeswoman claimed in an email that “there will be no data shared, collected or processed by Amazon and this is just an alternative way of providing readily available information from NHS.UK.”

When we spoke to DHSC on the phone prior to this, to raise the issue of medical voice query data generated via the partnership and fed to Amazon — also asking where in the contract are clauses to protect people’s data — the spokeswoman said she would have to get back to us.

All of which suggests the government has a very vague idea (to put it generously) of how cloud-powered voice AIs function.

Presumably no one at DHSC bothered to read the information on Amazon’s own Alexa privacy page — although the department spokeswomen was at least aware this page existed (because she knew Amazon had pointed us to what she called its “privacy notice”, which she said “sets out how customers are in control of their data and utterances”).

If you do read the page you’ll find Amazon offers some broad-brush explanation there which tells you that after an Alexa device has been woken by its wake word, the AI will “begin recording and sending your request to Amazon’s secure cloud”.

Ergo data is collected and processed. And indeed stored on Amazon’s servers. So, yes, data is ‘shared’.

The more detailed Alexa Internet Privacy Notice, meanwhile, sets out broad-brush parameters to enable Amazon’s reuse of Alexa user data — stating that “the information we learn from users helps us personalize and continually improve your Alexa experience and provide information about Internet trends, website popularity and traffic, and related content”. [emphasis ours]

The DHSC sees the matter very differently, though.

With no contractual binds covering health-related queries UK users of Alexa are being encouraged to whisper into Amazon’s robotic ears — data that’s naturally linked to Alexa and Amazon account IDs (and which the Alexa Internet Privacy Notice also specifies can be accessed by “a limited number of employees”) — the government is accepting the tech giant’s standard data processing terms for a commercial, consumer product which is deeply integrated into its increasingly sprawling business empire.

Terms such as indefinite retention of audio recordings — unless users pro-actively request that they are deleted. And even then Amazon admitted this summer it doesn’t always delete the text transcripts of recordings. So even if you keep deleting all your audio snippets, traces of medical queries may well remain on Amazon’s servers.

Earlier this year it also emerged the company employs contractors around the world to listen in to Alexa recordings as part of internal efforts to improve the performance of the AI.

A number of tech giants recently admitted to the presence of such ‘speech grading’ programs, as they’re sometimes called — though none had been up front and transparent about the fact their shiny AIs needed an army of external human eavesdroppers to pull off a show of faux intelligence.

It’s been journalists highlighting the privacy risks for users of AI assistants; and media exposure leading to public pressure on tech giants to force changes to concealed internal processes that have, by default, treated people’s information as an owned commodity that exists to serve and reserve their own corporate interests.

Data protection? Only if you interpret the term as meaning your personal data is theirs to capture and that they’ll aggressively defend the IP they generate from it.

So, in other words, actual humans — both employed by Amazon directly and not — may be listening to the medical stuff you’re telling Alexa. Unless the user finds and activates a recently added ‘no human review’ option buried in Alexa settings.

Many of these arrangements remain under regulatory scrutiny in Europe. Amazon’s lead data protection regulator in Europe confirmed in August it’s in discussions with it over concerns related to its manual reviews of Alexa recordings. So UK citizens — whose taxes fund the NHS — might be forgiven for expecting more care from their own government around such a ‘collaboration’.

Rather than a wholesale swallowing of tech giant T&Cs in exchange for free access to the NHS brand and  “NHS-verified” information which helps Amazon burnish Alexa’s utility and credibility, allowing it to gather valuable insights for its commercial healthcare ambitions.

To date there has been no recognition from DHSC the government has a duty of care towards NHS users as regards potential risks its content partnership might generate as Alexa harvests their voice queries via a commercial conduit that only affords users very partial controls over what happens to their personal data.

Nor is DHSC considering the value being generously gifted by the state to Amazon — in exchange for a vague supposition that a few citizens might go to the doctor a bit less if a robot tells them what flu symptoms look like.

“The NHS logo is supposed to mean something,” says Sam Smith, coordinator at patient data privacy advocacy group, MedConfidential — one of the organizations that makes use of the NHS’ free APIs for health content (but which he points out did not write its own contract for the government to sign).

“When DHSC signed Amazon’s template contract to put the NHS logo on anything Amazon chooses to do, it left patients to fend for themselves against the business model of Amazon in America.”

In a related development this week, Europe’s data protection supervisor has warned of serious data protection concerns related to standard contracts EU institutions have inked with another tech giant, Microsoft, to use its software and services.

The watchdog recently created a strategic forum that’s intended to bring together the region’s public administrations to work on drawing up standard contracts with fairer terms for the public sector — to shrink the risk of institutions feeling outgunned and pressured into accepting T&Cs written by the same few powerful tech providers.

Such an effort is sorely needed — though it comes too late to hand-hold the UK government into striking more patient-sensitive terms with Amazon US.

Every state but Alaska has reported vape lung victims, now numbering 1,479 nationwide

A lung condition apparently caused by vaping has been reported in every state but Alaska, the CDC has announced. The total number of suspected and confirmed cases has risen to 1,479, and at least 33 people have died as a result of the affliction.

The CDC (Centers for Disease Control and Prevention) updates these numbers regularly and provides news on its progress in characterizing the condition, in which the only reliable shared factor is using vaping devices. More victims report using THC products than nicotine, but no specific chemical or mechanism has been proposed as the cause.

At the outset it appeared that the problem might have been rooted in a bad batch of unofficial vape cartridges tinged with some toxic chemical — and indeed the CDC has warned against buying vaping materials from any untrustworthy sources. But the scale of the problem has continuously grown and is now clearly nationwide, not local.

The demographics skew male (70 percent of victims) and younger: 79 percent are under 35, with a median of 23 (though for deaths the median is 44). 78 percent reported using THC products, while only 10 percent reported only using nicotine.

Reported victims are concentrated in Illinois and California, in both of which over a hundred cases have been reported, but that should not be taken as an indicator that states with fewer cases, like Kentucky and Oregon, are immune — they may simply be late to report. Likewise for U.S. territories, where only the Virgin Islands have reported cases — Puerto Rico and others are likely to be equally at risk.

lung cases oct15

If you use a vaping device and are experiencing shortness of breath or chest pain (though other symptoms are also associated), you should probably check with your doctor. In the meantime the CDC has recommended ceasing all use of vaping products, though as many have pointed out that may end up pushing some users back to cigarettes. Angry about that? Direct it at the vaping companies, which promoted their products as smoking cessation tools without adequate testing.

The CDC and FDA, along with state and municipal health authorities and partners, are working on determining the cause and any potential treatments of the “lung injury associated with e-cigarette use,” as they call it. Tests and sampling efforts are underway — efforts that probably should have been done before these products were allowed on the market.

You can keep up with the latest stats at the CDC’s dedicated page.

Juul will stop selling mango, creme, fruit and cucumber pod flavors in the U.S.

Juul has stopped selling a number of its flavored nicotine products — mango, creme, fruit and cucumber — in the U.S., pending a review by the U.S. Food and Drug Administration. Now, the vaping company will only sell the flavors that taste like tobacco, mint or menthol in the U.S., the company announced today.

“We must reset the vapor category by earning the trust of society and working cooperatively with regulators, policymakers, and stakeholders to combat underage use while providing an alternative to adult smokers,” Juul CEO K.C. Crosthwaite said in a statement.

This comes after Juul stopped actively supporting San Francisco’s Proposition C, ceased its advertising campaigns in the U.S and stopped lobbying the FDA on its draft flavor guidance.

But this doesn’t mean Juul is giving up on selling these flavors in the future. The company said it will continue to try to develop scientific evidence to support the use of those flavored products, as well as develop stricter measures to combat underage usage. Meanwhile, Juul is still selling all of its flavors outside of the U.S.

Earlier this week, a parent who lost her child filed a wrongful lawsuit against Juul. That suit is just one of several lawsuits Juul faces.

Will unreliable research bury your healthcare startup?

For healthtech founders and funders, scientific claims and conclusions are more than policy — business models depend upon the lucid appraisal of clinical problems, evaluating inadequacies in current standards of care, a clear understanding of disease pathways, and designing superior interventions. 

At each step along this value chain, founders stand on the shoulders of the scientists that preceded them to obtain reliable evidence. When they promote their own innovations, credibility is a critical prerequisite. But where does credibility come from?

A 2012 study selecting 50 common cookbook ingredients found that 80% had publications linking their consumption to cancer risk; according to some reports, tomatoes, lemons, and celery all cause cancer. The to-and-fro of nutrition science is emblematic of a larger dynamic related to fickle research findings across disciplines. Because investigators seeking to build upon seminal studies struggle to reproduce the original findings, researchers have deemed the problem a reproducibility crisis

Simulations have found that up to 85% of published findings could not be replicated. In turn, tens of billions of dollars are wasted and countless patient lives are adversely impacted annually due to unreliable research. 

Historically, academic research and healthcare VC have had considerable overlap, but in recent years, this co-dependence has increased as researchers are looking more and more for financial support. Government research funding has seen a steady decline, with private sources now supporting almost 60% of the spend. Biomedical VC has been portrayed as a critical source of risk capital for early-stage research and a key engine for its translation at later stages.

UK biotech startup Mogrify injects $16M to get novel cell therapies to market soon

Cambridge, UK-based biotech startup Mogrify, which is working on systematizing the development of novel cell therapies in areas such as regenerative medicine, has closed an initial $16 million Series A.

The raise from investors Ahren Innovation CapitalParkwalk and 24Haymarket follows a $4M seed in February — taking its total raised to date to $20M.

Put simply, Mogrify’s approach entails analysis of vast amounts of genomic data in order to identify the specific energetic changes needed to flip an adult cell from one type to another without having to reset it to a stem cell state — with huge potential utility for a wide variety of therapeutic use-cases.

“What we’re trying to do with Mogrify is systematize that process where you can say here’s my source cell, here’s my target cell, here are the differences between the networks… and here are the most likely points of intervention that we’re going to have to make to drive the fate of an adult cell to another adult cell without going through a stem cell stage,” says CEO and investor Dr Darrin Disley.

So far he says it’s successfully converted 15 cells out of 15 tries.

“We’re now rapidly moving those on through our own programs and partnership programs,” he adds.

Mogrify’s business has three main components: Internal program development of cell therapies (current cell therapies it’s developing include enhancing augmented cartilage implantation; non-invasive treatment of ocular damage; and for blood disorders). It’s also developing a universal source of cells for use in immunotherapy — to act as “disease-eaters”, as Disley puts it.

Speculative IP development is another focus. “Because of the systematic nature of the technology we’re in a position very rapidly to identify areas of therapy that have particular cell conversions at their essence — and then drive that IP generation around those cells very quickly and create an IP footprint,” he says.

Partnering deals is the third piece. Mogrify is also working with others to co-develop and bring targeted cell therapies to market. Disley says it’s already closed some partnerships, though it’s not announcing any names yet.

The startup is drawing on around a decade’s worth of recent work genomics science. And specifically on a data-set generated by an international research effort, called Fantom 5, which its founders had early access to.

“We started with that massive Fantom data-set. That’s the baseline, the background if you like. Think of it like two cities in America: Chicago and New York. There’s your source cell, there’s your target cell. And because you have all the background data of every piece of the network — every building, every skyscraper — if you look at the two you can identify the difference in the gene expression, therefore you can identify which factors will regulate a wide array of those genes. So you can start identifying the differences between the two,” explains Disley.

“We’ve then added to that massive data sets in DNA-protein and protein-protein interactions… so you start to now overlay all of that data. And then we’ve added on top of that new next-gen sequencing data and epigenetic data. So you’ve now got this massive data-set. It’s like having a network map between all the different cell types. So you’re therefore then able to make predictions on how many interventions, what interventions are needed to drive that change of state — and it’s systematic. It doesn’t just recommend one set. There’s a ranking. It can go down to hundreds. And there is some overlap and redundancies, so for example if one — you’re preferred thing — doesn’t work the way you wanted it to you can go back and select another.

“Or if there’s an IP issue around that factor you can ignore that piece of the network and use an alternative route. And once you’ve got to your target cell, if it needs to some tweaking you can actually re-sequence it and take that back and that’s your starting cell again. And you can go through this optimization process. So what comes out at the other end… you’ve got a patent that it like a small molecule composition of matter patent; it’s the therapeutic. So you’re not coming out with the target, you’re actually coming out with here is the composition of matter on the cell.”

In terms of timeframe for getting novel cell therapies from concept to market Disley suggests a range of between four and seven years.

“Once you’ve identified the cell type that can be be the basis of your GMP manufacturable process and then you can tweak that to take it to the therapeutic indication you can develop a cell therapy and bring that to market in five years,” he says. “It’s not like the old days with small molecules where it can take ten, 15, 20 years to get a serious therapy on the market.

“When you’re treating patients… is because there are no other treatments for them, when you go into phase two and do your safety study [and] efficacy study you’re actually treating patients already in terms of their disease. And if you get it right you can get a fast track approval. Or a conditional approval… so that you may not even have to do a phase 3 [testing].”

“We’re not using any artificial intelligence here,” he also emphasizes, pointing to his experience investing in companies in the “big extreme data space” which he argues do best by using “unbiased approaches”.

“AI I think is still trying to find its way,” he continues. “Because in its essence it will be able to get to answers with smaller amounts of data but it’s only as good as the data you train it on. And the danger with AI… it just learns to recognize what you want it to recognize. It doesn’t know what it doesn’t know.

“In combination, once you continue to generate this massive cell network data etc you can start applying aspects of machine learning and AI. But you couldn’t do Mogrify with AI without the data. You have to do it that way. And the data is so complex and combinatorial — 2,000 transcription factors, in terms of regulation of those genes, they then interact in network to do the protein-protein interactions, you’ve got epigenetic aspects of that, you could even start adding cell microbiome effects to that later — so you’ve got a lot of factors that could influence the phenotype of the cell that’s coming out the other end.

“So I think with AI you have to be a little careful. I think it will be a more optimizing tool once you’ve got sufficient confidence in your system.”

The plan for the Series A funding is to ramp up Mogrify’s corporate operations and headcount — including bringing in senior executives and expertise from industry — as well as spending to fund its therapy development programs.

Disley notes its recent appointment of Dr Jane Osbourn as chair as one example.

“We’re bringing in more people with a lot of cell therapy experience from big pharma, around then more on the manufacturing and delivery of that — so really building so that we’re not just a tech company,” he says. “We’ve very strong already, we’re already 35 people on the tech and early stage drug discovery side — we’re going to add another 30 to that. But that’s going to be increasingly more people with big pharma, cell therapy development, manufacturing experience to get products on to market.”

Partner search is another focus for the Series A. “We’re trying to find the right strategy partners. We’re not doing services, we’re not doing products — so we want to find the right strategic partners in terms of doing multi-programs in a partnership,” he adds. “And then a series of more tactical deals where people have got a specific problem with a cell conversion. These more turnkey deals, if you like. We still get up-fronts, milestones and royalties but they’re smaller.”

Despite now having enough money for the next two to two and half years it’s also leaving the Series A open to continue expanding the round over the next 12 months — up to a maximum of another $16M.

“We have so many interested investors,” Disley tells us. “This round we didn’t actually open our round. We did it with internal investors and people we’re very close to who we’ve worked with before, and there were investors lining up… [so] we are leaving it open so that in these next 12 months we may choose to increase the amount we bring in.

“It would be a maximum of another $16M if it was an A round but we may decide just to go straight forward if we progress very fast to a much bigger B round.”

Startup says ‘Sober is the new black’

Maveron, Slow Ventures and Female Founders Fund have invested $10 million in a startup that claims it’s carving a new path to sobriety.

Tempest offers a $647 eight-week virtual “sobriety school” to help people, particularly women and “historically oppressed individuals,” get sober. The program is led by the company’s founder and chief executive officer Holly Whitaker, who conducts weekly video lectures and Q+As for participants. Offering their expertise as part of the package is marriage and family therapist Kim Kokoska; Valerie (Vimalasara) Mason-John, the co-founder of Eight Step Recovery; and wellness coach Mary Vance, among others.

Tempest teaches the underlying causes of addiction and the “importance of purpose, meaning and creativity in breaking addiction,” as well as how to manage cravings, how to navigate social situations as a non-drinker, how to develop a mindfulness practice and more. At the end of the program, participants can pay a $127 fee for an annual membership to the Tempest online community, where one can communicate with others who’ve completed the program.

Tempest Syllabus
Week 1: Recovery Maps + Toolkits
Week 2: Addiction & The Brain
Week 3: Habit and Night Ritual
Week 4: Yoga, Meditation and Breath
Week 5: Nutrition & Lifestyle
Week 6: Relationships & Community
Week7: Trauma & Therapy
Week 8: Purpose & Creativity
Week 8+ Wrapping Up + Next Steps

Dashboard Week 2

A snapshot of Tempest’s weekly coursework.

A holistic approach

Founded in 2014, New York-based Tempest has raised about $14.3 million in total VC funding. Whitaker previously spent five years at One Medical, where she was the director of revenue cycle operations. Since founding Tempest, which has enrolled 4,000 participants to date, Whitaker received a two-book deal from Random House to document her methodologies and path to sobriety. Her first book, ‘Quit Like a Woman: The Radical Choice to Not Drink in a Culture Obsessed with Alcohol,’ will be released on December 31.

Today, her business has 28 employees and plans to build out its team, invest in marketing — where it’s historically had very low spend — and explore business opportunities within the enterprise using cash from the $10 million Series A.

“Sobriety, and the refusal to partake in alcogenic culture, is subversive, rebellious, and edgy.” - Tempest

The company is careful to clarify it’s not a detox or 12-step program, like Alcoholics Anonymous, which is structured around the Twelve Steps to recovery. Rather, Tempest can be used in combination with other programs or therapies, or as a first step down the path to recovery. Whitaker explains Tempest isn’t only for the clinically addicted or those who consider themselves addicts or alcoholics. The company welcomes people who have rejected these labels or simply want to cut alcohol out of their life.

“Tempest grew out of my own experience,” Whitaker, who has previously struggled with alcoholism and an eating disorder, tells TechCrunch. “It was a response to the lack of desirable and accessible options to address problematic drinking, the lack of options available for people who don’t identify as alcoholics but struggle with alcohol and the lack of options that have been created for women and other individuals. Everything had been created for men.”

Tempest is tailored to the needs of women and historically oppressed individuals, says Whitaker, though all genders are welcome to complete its course. Taking a holistic approach to recovery, participants are encouraged to address the factors that led them to drink in the first place, including “love lives, poor nutrition, stress, anxiety, crap friendships, consumerism, lack of purpose, unresolved family of origin issues, disenfranchisement, poverty, tight or unmanageable finances, lack of connection, fear, shitty jobs we hate, depression, unprocessed trauma, lack of meaning, unfulfilled dreams, never-ending to-do lists, never-measuring-upness,” the company writes.

TempestWebsite

Tempest’s website

But what about A.A.?

I had the same question.

Alcoholics Anonymous (A.A.), the most popular and accessible approach to recovery, is free and open to anyone willing to acknowledge they have a drinking problem. A nonprofit organization, A.A. has more than 115,000 groups worldwide. The 84-year-old program is built on peer-support groups that gather regularly for discussion meetings. Over time, more seasoned members can become “sponsors,” helping newer entrants work through the Twelve Steps.

Tempest, alternatively, is taking a for-profit approach, charging for its tech-infused method. And where A.A. emphasizes in-person support groups, Tempest relies on video streams. Increasingly, telemedicine startups are enticing customers with convenient options for health and wellness care but whether people will truly pivot to telemedicine, tele-therapy or virtual sobriety schools is still up for debate. As for Tempest’s similarities to A.A., Whitaker says: “The only thing they have in common is that they are working to help people quit alcohol.”

“By just trying on sobriety or questioning our drink-centric culture, you are profoundly ahead of the pack.” - Tempest

In selling its sobriety school, Tempest evokes a sense of coolness, with phrases like “Sober is the new black” and “Your hangover goes away. Your social life doesn’t,” plastered on its website. In providing a priced and more exclusive route to sobriety, one might question Tempest’s ethics and motivations as it builds a business that capitalizes off of substance abuse. Whitaker, in defense, explains a virtual school fit for the historically powerless is a necessary addition to existing options: “Our program is centered on individuals who have been held out of power, who have been told to shut up and listen,” she said. “We aren’t looking at white, upper-class men. We are looking at a queer person from 2019.”

According to survey data published by Recovery.org, 89% of A.A. attendees are white, while 38% are female.

Refusing ‘alcogenic culture’

Tempest’s branding takes a cue from the D2C playbook. The company, led by women, has the opportunity to become the brand that represents sobriety, and it’s taking it. Tempest’s Series A, coupled with the influx of new-age non-alcoholic beverage brands backed by VCs, is representative of the perceived shift away from alcohol among the younger generations.

Millennials are drinking less alcohol and, according to the World Health Organization, there are 5% fewer alcohol drinkers in the world today than in 2000. Tempest’s school seems to cater more to the cohort of people who view ditching alcohol as a lifestyle perk, not those who stop drinking due to addiction.

Holly Whitaker

Tempest founder and CEO Holly Whitaker

Seedlip, a non-alcoholic spirits company, and India’s Coolberg Beverages, which makes non-alcoholic beer, recently raised VC to cater to a similar demographic. Meanwhile, CBD-infused beverage brands like Sweet Reason, Cann and Recess are trendy and raising venture money. None of these, of course, are solutions for someone struggling with alcohol. Capital flowing into these brands merely indicates venture capitalists’ belief that consumers are steering away from traditional liquor and toward new products fit for a generation that is drinking less alcohol.

“By just trying on sobriety or questioning our drink-centric culture, you are profoundly ahead of the pack and among good company,” Tempest writes on its website. “Remember: 70-80% of adults drink depending on where you live; drinking is basic. Sobriety, and the refusal to partake in alcogenic culture, is subversive, rebellious, and edgy.”

Tempest says it has completed an efficacy study performed in consultation with researchers affiliated with the University of Buffalo and Syracuse University. In several years’ time, we’ll know whether the countless think pieces claiming millennials are done with alcohol were indeed true and whether the VC money into these upstarts was wasted or pure genius. As for Tempest, even if just providing a designated place on the internet for discussions around the struggles or benefits of sobriety, it has the potential to make a big impact on those in recovery or those seeking a lifestyle change.

“Alcohol is very similar to cigarettes,” Whitaker said. “We are in a time that we think drinking alcohol is natural, that we are supposed to do it. I thought that would change because to me, alcohol is entirely toxic. We are approaching this tipping point of realizing how toxic and unnecessary it is.”

Tempest is also backed by AlleyCorp, Refactor and Green D Ventures. Maveron’s Anarghya Vardhana has joined the startup’s board of directors as part of the latest deal.

This startup just raised $8 million to help busy doctors assess the cognitive health of 50 million seniors

All over the globe, the population of people who are aged 65 and older is growing faster than every other age group. According to United Nations data, by 2050, one in six people in the world will be over age 65, up from one in 11 right now. Meanwhile, in Europe and North America, by 2050, one in four people could be 65 or over.

Unsurprisingly, startups increasingly recognize opportunities to cater to this aging population. Some are developing products to sell to individuals and their family members directly; others are coming up with ways to empower those who work directly with older Americans.

BrainCheck, a 20-person, Houston-based startup whose cognitive healthcare product aims to help physicians assess and track the mental health of their patients, is among the latter. Investors like what it has put together, too. Today, the startup is announcing $8 million in Series A funding round co-led by S3 Ventures and Tensility Venture Partners.

We talked earlier today with BrainCheck cofounder and CEO Yael Katz to better understand what her company has created and why it might be of interest to doctors who don’t know about it. Our chat has been edited for length and clarity.

TC: You’re a neuroscientist. You started BrianCheck with David Eagleman, another neuroscientist and the CEO of NeoSensory, a company that develops devices for sensory substitution. Why? What’s the opportunity here?

YK: We looked across the landscape, and we realized that most cognitive assessment is [handled by] a subspecialty of clinical psychology called neuropsychology, where patients are given a series a tests and each is designed to probe a different type of brain function — memory, visual attention, reasoning, executive function. They measure speed and accuracy, and based on that, determine whether there’s a deficit in that domain. But the tests were classically done on paper and it was a lengthy process. We digitized them and gamified them and made them accessible to everyone who are upstream of neuropsychology, including neurologists and primary care doctors.

We created a tech solution that provides clinical decision support to physicians so they can manage patients’ cognitive health. There are 250,000 primary care physicians in the U.S. and 12,000 neurologists and [they’re confronting] what’s been called a silver tsunami. With so many becoming elderly, it’s not possible for them to address the need of the aging population without tech to help them.

TC: How does your product work, and how is it administered?

YK: An assessment is all done on an iPad and takes about 10 minutes. They’re typically administered in a doctor’s office by medical technicians, though they can be administered remotely through telemedicine, too.

TC: These are online quizzes?

YK: Not quizzes and not subjective questions like, ‘How do you think you’re doing?’ but rather objective tasks, like connect the dots, and which way is the center arrow pointing — all while measuring speed and accuracy.

TC: How much does it cost these doctors’ offices, and how are you getting word out?

YZ: We sell a monthly subscription to doctors and it’s a tiered pricing model as measured by volume. We meet doctors at conferences and we publish blog posts and white papers and through that process, we meet them and sell products to them, beginning with a free trial for 30 days, during which time we also give them a web demo.

[What we’re selling] is reimbursable by insurance because it helps them report on and optimize metrics like patient satisfaction. Medicare created a new code to compensate doctors for cognitive care planning though it was rarely used because the requirements and knowledge involved was so complicated. When we came along, we said, let us help you do what you’re trying to do, and it’s been very rewarding.

TC: Say one of these assessments enables a non specialist to determine that someone is losing memory or can’t think as sharply. What then?

YZ: There’s a phrase: “Diagnose and adios.” Unfortunately, a lot of doctors used to see their jobs as being done once an assessment was made. It wasn’t appreciated that impairment and dementia are things you can address. But about one third of dementia is preventable, and once you have the disease, it can be slowed.  It’s hard because it requires a lot of one-on-one work, so we created a tech solution that uses the output of tests to provide clinical support to physicians so they can manage patients’ cognitive health. We provide personalized recommendations in a way that’s scalable.

TC: Meaning you suggest an action plan for the doctors to pass along to their patients based on these assessments?

YZ: There are nine modifiable risk factors found to account for a third of [dementia cases], including certain medications that can exacerbate cognitive impairment, including poorly controlled cardiovascular health, hearing impairment, and depression. People can have issues for many reasons — multiple sclerosis, epilepsy, Parkinson’s — but health conditions like major depression and physical conditions like cancer and treatments like chemotherapy can cause brain fog. We suggest a care plan that goes to the doctor who then uses that information and modifies it. A lot of it has to do with medication management.

A lot of the time, a doctor — and family members — don’t know how impaired a patient is. You can have a whole conversation with someone during a doctor’s visit who is regaling you with great conversation, then you realize they have massive cognitive deficits. These assessments kind of put everyone on the same page.

TC: You’ve raised capital. How will you use it to move your product forward?

YK: We’ll be combining our assessments with digital biomarkers like changing voice patterns and a test of eye movements. We’ve developed an eye-tracking technology and voice algorithms, but those are still in clinical development; we’re trying to get FDA approval for them now.

TC: Interesting that changing voice patterns can help you diagnose cognitive decline.

YK: We aren’t diagnosing disease. Think of us as a thermometer that [can highlight] how much impairment is there and in what areas and how it’s progressed over time.

TC: What can you tell readers who might worry about their privacy as it relates to your product?

YK: Our software is HIPAA compliant. We make sure our engineers are trained and up to date. The FDA requires that we we put a lot of standards in place and we ensure that our database is built in accordance with best practices. I think we’re doing as good a job as anyone can.

Privacy is a concern in general. Unfortunately, companies big and small have to be ever vigilant about a data breach.

83North closes $300M fifth fund focused on Europe, Israel

83North has closed its fifth fund, completing an oversubscribed $300 million raise and bringing its total capital under management to $1.1BN+.

The VC firm, which spun out from Silicon Valley giant Greylock Partners in 2015 — and invests in startups in Europe and Israel, out of offices in London and Tel Aviv — last closed a $250M fourth fund back in 2017.

It invests in early and growth stage startups in consumer and enterprise sectors across a broad range of tech areas including fintech, data centre & cloud, enterprise software and marketplaces.

General partner Laurel Bowden, who leads the fund, says the latest close represents investment business as usual, with also no notable changes to the mix of LPs investing for this fifth close.

“As a fund we’re really focused on keeping our fund size down. We think that for just the investment opportunity in Europe and Israel… these are good sized funds to raise and then return and make good multiples on,” she tells TechCrunch. “If you go back in the history of our fundraising we’re always somewhere between $200M-$300M. And that’s the size we like to keep.”

“Of course we do think there’s great opportunities in Europe and Israel but not significantly different than we’ve thought over the last 15 years or so,” she adds.

83North has made around 70 investments to date — which means its five partners are usually making just one investment apiece per year.

The fund typically invests around $1M at the seed level; between $4M-$8M at the Series A level and up to $20M for Series B, with Bowden saying around a quarter of its investments go into seed (primarily into startups out of Israel); ~40% into Series A; and ~30% Series B.

“It’s somewhat evenly mixed between seed, Series A, Series B — but Series A is probably bigger than everything,” she adds.

It invests roughly half and half in its two regions of focus.

The firm has had 15 exits of portfolio companies (three of which it claims as unicorns). Recent multi-billion dollar exits for Bowden are: Just Eat, Hybris (acquired by SAP), iZettle (acquired by PayPal) and Qlik.

While 83North has a pretty broad investment canvas, it’s open to new areas — moving into IoT (with recent investments in Wiliot and VDOO), and also taking what it couches as a “growing interest” in healthtech and vertical SaaS. 

“Some of my colleagues… are looking at areas like lidar, in-vehicle automation, looking at some of the drone technologies, looking at some even healthtech AI,” says Bowden. “We’ve looked at a couple of those in Europe as well. I’ve looked, actually, at some healthtech AI. I haven’t done anything but looked.

“And also all things related to data. Of course the market evolves and the technology evolves but we’ve done things related to BI to process automation through to just management of data ops, management of data. We always look at that area. And think we’ll carry on for a number of years. ”

“In venture you have to expand,” she adds. “You can’t just stay investing in exactly the same things but it’s more small additional add-ons as the market evolves, as opposed to fundamental shifts of investment thesis.”

Discussing startup valuations, Bowden says European startups are not insulated from wider investment dynamics that have been pushing startup valuations higher — and even, arguably, warping the market — as a consequence of more capital being raised generally (not only at the end of the pipe).

“Definitely valuations are getting pushed up,” she says. “Definitely things are getting more competitive but that comes back to exactly why we’re focused on raising smaller funds. Because we just think then we have less pressure to invest if we feel that valuations have got too high or there’s just a level… where startups just feel the inclination to raise way more money than they probably need — and that’s a big reason why we like to keep our fund size relatively small.”

Amid mounting concerns around vaping cannabis, entrepreneurs say regulators need to step up

As concerns over the safety of vaping products for cannabis sweeps across the country, executives in the industry are passing the buck to regulators to come up with a solution.

The need for national regulation touches everything from how to bank cannabis businesses to how to manage the distribution of cannabis products, but the pain is most acute as vaping-related illnesses sweep the United States.

To date, the CDC has recorded roughly 1,080 lung injury cases associated with using e-cigarette, or vaping, products in 48 states and one U.S. territory. According to the agency, 18 deaths have been confirmed in 15 states, so far. And most of those patients report a history of using THC-containing products.

“I want the CDC and the regulatory bodies that are actually looking into the case to kind of investigate those causes and come back,” said Bharat Vasan, the former chief executive officer at Pax Labs, a marijuana vaporizer manufacturer, speaking onstage at Disrupt San Francisco 2019. Vasan declined to address whether Pax Labs products could be considered 100% safe. “I think that’s a good question for the company,” said the former chief executive who had worked for Pax for over a year.

Both Vasan, who now runs a consumer-focused incubator, Yellow Dog Ventures, and Eaze and Wayv founder Keith McCarty, think that more regulation would fuel growth and provide more stability for a market that’s already the fastest-growing industry in the United States.

“It’s like the final stage of prohibition,” says Vasan. “It’s ending, but it’s ending state by state by state for cannabis.”

Keith McCarty WayvDSC03851

New bills like the SAFE Act, which recently passed the House of Representatives, would allow national banks to work with cannabis companies. The lack of access to appropriate financial services has been one source of friction in the U.S. cannabis industry. Although it hasn’t stopped any number of entrepreneurs like Vasan, McCarty and others from launching businesses to serve the industry.

Still, it’s a bit of a scary time for many executives in the industry. Bruce Linton was ousted at Canopy Growth, and chief operating officer Ben Cook and General Counsel Lisa Sergi Trager, resigned from MedMen Enterprises. And there’s still a potentially toxic cloud of vapor hanging over the industry in the form of additives and chemicals that have been linked to wave of lung illnesses that swept through the country over the past year, according to the Food and Drug Administration and the Centers for Disease Control.

Despite the headwinds for vaping, America is clearly becoming cannabis country. “It still happens to be the fastest-growing industry in the world,” McCarty said. And even though venture capital investors can’t invest into the industry directly, the ancillary services, products and logistic requirements to build a fully functioning, mature industry, represents a significant opportunity for entrepreneurs.

“The market and the population is saying through sentiment that we want this,” said McCarty, [and] this industry continues to move in the right direction… up and to the right.”

At the same time, McCarty also sees the need for more government regulation to move the industry fully into the realm of legitimate, regulated enterprises and rid cannabis of the grey and black market operators that have far more freedom to sell harmful products, thanks to their under-the-table operations.

“We have three times as many illicit dispensaries as we do ones that are legal in the state of California,” says McCarty. “And what the voters voted in is safe access. Safe access is about availability of access points to be able to receive and consume cannabis based on the law and regulations.”

Ultimately, McCarty sees the support for the continuing integration of cannabis products as legal medical and recreational options as something that should have bi-partisan support.

“Our government should be looking at voter sentiment and the population . . . is overwhelmingly in support of cannabis . . . well beyond that for medical and even for recreational . . . so it’s probably one of the . . . only items on the agenda, too, that is bipartisan, like truly supported by parties,” McCarty says. “I’m talking about putting money towards schools, books, education as opposed to all the illicit things that we’re trying to break away from, like the illicit sale of things that you know that may be harming people from a health and wellness perspective.”