Two former Qualcomm engineers are using AI to fix China’s healthcare problem

Artificial intelligence is widely heralded as something that could disrupt the jobs market across the board — potentially eating into careers as varied as accountants, advertising agents, reporters and more — but there are some industries in dire need of assistance where AI could make a wholly positive impact, a core one being healthcare.

Despite being the world’s second-largest economy, China is still coping with a serious shortage of medical resources. In 2015, the country had 1.8 physicians per 1,000 citizens, according to data compiled by the Organization for Economic Cooperation and Development. That figure puts China behind the U.S. at 2.6 and was well below the OECD average of 3.4.

The undersupply means a nation of overworked doctors who constantly struggle to finish screening patient scans. Misdiagnoses inevitably follow. Spotting the demand, forward-thinking engineers and healthcare professionals move to get deep learning into analyzing medical images. Research firm IDC estimates that the market for AI-aided medical diagnosis and treatment in China crossed 183 million yuan ($27 million) in 2017 and is expected to reach 5.88 billion yuan ($870 million) by 2022.

One up-and-comer in the sector is 12 Sigma, a San Diego-based startup founded by two former Qualcomm engineers with research teams in China. The company is competing against Yitu, Infervision and a handful of other well-funded Chinese startups that help doctors detect cancerous cells from medical scans. Between January and May last year alone, more than 10 Chinese companies with such a focus scored fundings of over 10 million yuan ($1.48 million), according to startup data provider Iyiou. 12 Sigma itself racked up a 200 million yuan Series B round at the end of 2017 and is mulling a new funding round as it looks to ramp up its sales team and develop new products, the company told TechCrunch.

“2015 to artificial intelligence is like 1995 to the Internet. It was the dawn of a revolution,” recalled Zhong Xin, who quit his management role at Qualcomm and went on to launch 12 Sigma in 2015. At the time, AI was cereping into virtually all facets of life, from public security, autonomous driving, agriculture, education to finance. Zhong took a bet on health care.

“For most industries, the AI technology might be available, but there isn’t really a pressing problem to solve. You are creating new demand there. But with healthcare, there is a clear problem, that is, how to more efficiently spot diseases from a single image,” the chief executive added.

An engineer named Gao Dashan who had worked closely with Zhong at Qualcomm’s U.S. office on computer vision and deep learning soon joined as the startup’s technology head. The pair both attended China’s prestigious Tsinghua University, another experience that boosted their sense of camaraderie.

Aside from the potential financial rewards, the founders also felt an urge to start something on their own as they entered their 40s. “We were too young to join the Internet boom. If we don’t create something now for the AI era, it will be too late for us to be entrepreneurs,” admitted Zhong who, with age, also started to recognize the vulnerability of life. “We see friends and relatives with cancers get diagnosed too late and end up  The more I see this happen, the more strongly I feel about getting involved in healthcare to give back to society.”

A three-tier playbook

12 Sigma and its peers may be powering ahead with their advanced imaging algorithms, but the real challenge is how to get China’s tangled mix of healthcare facilities to pay for novel technologies. Infervision, which TechCrunch wrote about earlier, stations programmers and sales teams at hospitals to mingle with doctors and learn their needs. 12 Sigma deploys the same on-the-ground strategy to crack the intricate network.

12 sigma

Zhong Xin, Co-founder and CEO of 12 Sigma / Photo source: 12 Sigma

“Social dynamics vary from region to region. We have to build trust with local doctors. That’s why we recruit sales persons locally. That’s the foundation. Then we begin by tackling the tertiary hospitals. If we manage to enter these hospitals,” said Zhong, referring to the top public hospitals in China’s three-tier medical system. “Those partnerships will boost our brand and give us greater bargaining power to go after the smaller ones.”

For that reason, the tertiary hospitals are crowded with earnest startups like 12 Sigma as well as tech giants like Tencent, which has a dedicated medical imaging unit called Miying. None of these providers is charging the top boys for using their image processors because “they could easily switch over to another brand,” suggested Gao.

Instead, 12 Sigma has its eyes on the second-tier hospitals. As of last April, China had about 30,000 hospitals, out of which 2,427 were rated tertiary, according to a survey done by the National Health and Family Planning Commission. The second tier, serving a wider base in medium-sized cities, had a network of 8,529 hospitals. 12 Sigma believes these facilities are where it could achieve most of its sales by selling device kits and charging maintenance fees in the future.

The bottom tier had 10,135 primary hospitals, which tend to concentrate in small towns and lack the financial capacity to pay the one-off device fees. As such, 12 Sigma plans to monetize these regions with a pay-per-use model.

So far, the medical imaging startup has about 200 hospitals across China testing its devices — for free. It’s sold only 10 machines, generating several millions of yuan in revenue, while very few of its rivals have achieved any sales at all according to Gao. At this stage, the key is to glean enough data so the startup’s algorithms get good enough to convince hospital administrators the machines are worth the investment. The company is targeting 100 million yuan ($14.8 million) in sales for 2019 and aims to break even by 2020.

China’s relatively lax data protection policy means entrepreneurs have easier access to patient scans compared to their peers in the west. Working with American hospitals has proven “very difficult” due to the country’s privacy protection policies, said Gao. They also come with a different motive. While China seeks help from AI to solve its doctor shortage, American hospitals place a larger focus on AI’s economic returns.

“The healthcare system in the U.S. is much more market-driven. Though doctors could be more conservative about applying AI than those in China, as soon as we prove that our devices can boost profitability, reduce misdiagnoses and lower insurance expenditures, health companies are keen to give it a try,” said Gao.

Two former Qualcomm engineers are using AI to fix China’s healthcare problem

Artificial intelligence is widely heralded as something that could disrupt the jobs market across the board — potentially eating into careers as varied as accountants, advertising agents, reporters and more — but there are some industries in dire need of assistance where AI could make a wholly positive impact, a core one being healthcare.

Despite being the world’s second-largest economy, China is still coping with a serious shortage of medical resources. In 2015, the country had 1.8 physicians per 1,000 citizens, according to data compiled by the Organization for Economic Cooperation and Development. That figure puts China behind the U.S. at 2.6 and was well below the OECD average of 3.4.

The undersupply means a nation of overworked doctors who constantly struggle to finish screening patient scans. Misdiagnoses inevitably follow. Spotting the demand, forward-thinking engineers and healthcare professionals move to get deep learning into analyzing medical images. Research firm IDC estimates that the market for AI-aided medical diagnosis and treatment in China crossed 183 million yuan ($27 million) in 2017 and is expected to reach 5.88 billion yuan ($870 million) by 2022.

One up-and-comer in the sector is 12 Sigma, a San Diego-based startup founded by two former Qualcomm engineers with research teams in China. The company is competing against Yitu, Infervision and a handful of other well-funded Chinese startups that help doctors detect cancerous cells from medical scans. Between January and May last year alone, more than 10 Chinese companies with such a focus scored fundings of over 10 million yuan ($1.48 million), according to startup data provider Iyiou. 12 Sigma itself racked up a 200 million yuan Series B round at the end of 2017 and is mulling a new funding round as it looks to ramp up its sales team and develop new products, the company told TechCrunch.

“2015 to artificial intelligence is like 1995 to the Internet. It was the dawn of a revolution,” recalled Zhong Xin, who quit his management role at Qualcomm and went on to launch 12 Sigma in 2015. At the time, AI was cereping into virtually all facets of life, from public security, autonomous driving, agriculture, education to finance. Zhong took a bet on health care.

“For most industries, the AI technology might be available, but there isn’t really a pressing problem to solve. You are creating new demand there. But with healthcare, there is a clear problem, that is, how to more efficiently spot diseases from a single image,” the chief executive added.

An engineer named Gao Dashan who had worked closely with Zhong at Qualcomm’s U.S. office on computer vision and deep learning soon joined as the startup’s technology head. The pair both attended China’s prestigious Tsinghua University, another experience that boosted their sense of camaraderie.

Aside from the potential financial rewards, the founders also felt an urge to start something on their own as they entered their 40s. “We were too young to join the Internet boom. If we don’t create something now for the AI era, it will be too late for us to be entrepreneurs,” admitted Zhong who, with age, also started to recognize the vulnerability of life. “We see friends and relatives with cancers get diagnosed too late and end up  The more I see this happen, the more strongly I feel about getting involved in healthcare to give back to society.”

A three-tier playbook

12 Sigma and its peers may be powering ahead with their advanced imaging algorithms, but the real challenge is how to get China’s tangled mix of healthcare facilities to pay for novel technologies. Infervision, which TechCrunch wrote about earlier, stations programmers and sales teams at hospitals to mingle with doctors and learn their needs. 12 Sigma deploys the same on-the-ground strategy to crack the intricate network.

12 sigma

Zhong Xin, Co-founder and CEO of 12 Sigma / Photo source: 12 Sigma

“Social dynamics vary from region to region. We have to build trust with local doctors. That’s why we recruit sales persons locally. That’s the foundation. Then we begin by tackling the tertiary hospitals. If we manage to enter these hospitals,” said Zhong, referring to the top public hospitals in China’s three-tier medical system. “Those partnerships will boost our brand and give us greater bargaining power to go after the smaller ones.”

For that reason, the tertiary hospitals are crowded with earnest startups like 12 Sigma as well as tech giants like Tencent, which has a dedicated medical imaging unit called Miying. None of these providers is charging the top boys for using their image processors because “they could easily switch over to another brand,” suggested Gao.

Instead, 12 Sigma has its eyes on the second-tier hospitals. As of last April, China had about 30,000 hospitals, out of which 2,427 were rated tertiary, according to a survey done by the National Health and Family Planning Commission. The second tier, serving a wider base in medium-sized cities, had a network of 8,529 hospitals. 12 Sigma believes these facilities are where it could achieve most of its sales by selling device kits and charging maintenance fees in the future.

The bottom tier had 10,135 primary hospitals, which tend to concentrate in small towns and lack the financial capacity to pay the one-off device fees. As such, 12 Sigma plans to monetize these regions with a pay-per-use model.

So far, the medical imaging startup has about 200 hospitals across China testing its devices — for free. It’s sold only 10 machines, generating several millions of yuan in revenue, while very few of its rivals have achieved any sales at all according to Gao. At this stage, the key is to glean enough data so the startup’s algorithms get good enough to convince hospital administrators the machines are worth the investment. The company is targeting 100 million yuan ($14.8 million) in sales for 2019 and aims to break even by 2020.

China’s relatively lax data protection policy means entrepreneurs have easier access to patient scans compared to their peers in the west. Working with American hospitals has proven “very difficult” due to the country’s privacy protection policies, said Gao. They also come with a different motive. While China seeks help from AI to solve its doctor shortage, American hospitals place a larger focus on AI’s economic returns.

“The healthcare system in the U.S. is much more market-driven. Though doctors could be more conservative about applying AI than those in China, as soon as we prove that our devices can boost profitability, reduce misdiagnoses and lower insurance expenditures, health companies are keen to give it a try,” said Gao.

As threats proliferate, so do new tools for protecting medical devices and hospitals

Six months after an episode of “Homeland” showed hackers exploiting security vulnerabilities in the (fictional) Vice President’s pacemaker, Mike Kijewski, the founder of a new startup security company called Medcrypt, was approached by his (then) employers at Varian Medical Systems with a unique problem. 

“A hospital came to the company and said we are treating a patient and a nation-state may attempt to assassinate the patient that we’re treating by using a cybersecurity vulnerability in a medical device to do it,” Kijewski recalled.

At the time, there were no universal solutions to those types of security threats — so companies were left to cobble together one-off solutions for their devices, which is what Kijewski’s former employer likely attempted to do.

Ever since, Kijewski became obsessed with the security holes that exist in the foundation of the healthcare industry’s practice — the devices used to diagnose and treat patients.

“My partner Eric Pancoast and I looked into the problem of medical device cybersecurity and we found two things,” says Kijewski. “Number one there were no regulations forcing medical device companies to use cybersecurity protections at all. Number two, any given company has only one core competency — maybe two. And are medical device vendors going to have cryptography and cybersecurity competencies?”

Medcrypt was launched in 2016 to ensure that medical device manufacturers wouldn’t need to be cryptographic experts. The company is graduating from the latest batch of Y Combinator (after raising a $3 million seed round from Eniac Ventures and other investors) with a pitch to secure medical devices using just a single line of code.

It’s a technological necessity thanks to new guidelines from the Food and Drug Administration requiring medical devices to include security features like encryption, signature verification, and intrusion detection.

By inserting a single line of code into the software of a device, Medcrypt can provide the security manufacturers need at the device level, according to Kijewski.

The company not only encrypts the data on the device, but it also provide intrusion detection services by analyzing medical device metadata to identify standard device behaviors and deviations from that behavior, Kijewski said.

Medcrypt is one of a growing number of startups that are securing medical devices and hospital networks as the threats to the healthcare system proliferate.

Other startups are working on protecting hospital networks. Companies like Medigate, founded by ex-Israeli officers from the Israeli Defense Forces, which just raised $15 million from investors including YL Ventures and US Venture Partners; and Cylera, which is backed by Samsung Next and launched from the DreamIT healthcare accelerator are two such companies.

By 2017, Beckers Health IT and CIO Report counted over 107 technology companies pitching cybersecurity solutions to healthcare practitioners and medical device manufacturers.

It’s little wonder so many companies are pouring in to close the (data) breach in healthcare, given the scope of the problem.

A 2018 report from Experian cited by U.S. News indicated that 233 breaches were reported to the Department of Health and Human Services, media, or state attorneys general in the period from January to June 2017. And for the 193 attacks where the scope of the breach was calculated, roughly 3.2 million patient records were affected.

Experian predicts healthcare cybersecurity spending will be a $65 billion industry by 2021.

Still, some of the security problems that hospitals face can be solved with some fairly basic updates. Indeed, perhaps the most critical — and the one that left hospitals most exposed — is just ensuring that their technology can accept patches and security upgrades. Many of the attacks that crippled health networks came down to an inability to upgrade their Windows operating systems.

Sometimes, all it takes is tightening the screws to make sure the machines don’t fall apart.

“Connected medical devices — from patient monitors, MRIs and CAT scanners to infusion pumps and yet-to-be invented devices — are critical to the delivery of healthcare today and are revolutionizing the care of tomorrow,” said YL Ventures founder Yoav Leitersdorf in a statement announcing Medigate’s 2017 financing. “These devices are inherently different from traditional IT endpoints and can’t be protected by currently available products and practices. With the pandemic of cyberattacks targeting healthcare providers, far too many connected devices are left vulnerable and exposed, putting patient health and privacy at risk.”

 

Healthcare wearables level up with new moves from Apple and Alphabet

Announcements that Apple has partnered with Aetna health insurance on a new app leveraging data from its Apple Watch and reports that Verily — one of the health-focused subsidiaries of Google‘s parent company — Alphabet, is developing a shoe that can detect weight and movement, indicate increasing momentum around using data from wearables for clinical health applications and treatments.

For venture capital investors, the movea from Apple and Alphabet to show new applications for wearable devices is a step in the right direction — and something that’s been long overdue.

“As a healthcare provider, we talk a lot about the important of preventative medicine, but the US healthcare system doesn’t have the right incentives in place to pay for it,” writes Cameron Sepah, an entrepreneur in residence at Trinity Ventures. “Since large employers largely pay for health care (outside of Medicaid and Medicare), they usually aren’t incentivized to pay for prevention, since employees don’t stay long enough for them to incur the long-term costs of health behaviors. So most startups in this space end up becoming an expendable wellness perk for companies. However, if an insurer like Aetna keeps its members long enough, there’s better alignment for disseminating this app.”

Sepah sees broader implications for the tie ups between health insurers and the tech companies making all sorts of devices to detect and diagnose conditions.

“Most patients relationship with their insurer is just getting paper bills/notifications in the mail, with terrible customer satisfaction (NPS) across the board,” Sepah wrote in an email. “But when there’s a way to build a closer relationship through a device that sits on your wrist, it opens possibilities to partner with other health tech startups that can notify patients when they are having mental health issues before they even recognize it (e.g. Mindstrong); or when they should get treatment for hypertension or sleep apnea (e.g. Cardiogram); or leverage their data into a digital chronic disease treatment program (e.g. Omada Health).”

Aetna isn’t the first insurer to tie Apple Watch data to their policies. In September 2018, John Hancock launched the Vitality program, which also gave users discounts on the latest Apple Watch if they linked it with John Hancock’s app. The company also gave out rewards if users changed their behavior around diet and exercise.

In a study conducted by Rand Europe of 400,000 people in the U.S., the U.K., and South Africa, research showed that users who wore an Apple Watch and participated in the Vitality benefits program averaged a 34 percent increase in physical activity compared to patients without the Apple Watch. It equated to roughly 5 extra days of working out per month.

“[It will] be interesting to see how CVS/Apple deal unfolds. Personalized health guidance based on a combination of individual medical records and real time wearable data is a huge and worthy goal,” wrote Greg Yap, a partner at the venture capital firm, Menlo Ventures . But, Yap wrote,I’m skeptical their first generation app will have enough data or training to deliver value to a broad population, but we’re likely to see some anecdotal benefits, and I find that worthwhile.”

Meanwhile the types of devices that record consumer health information are proliferating — thanks in no small part to Verily.

With the company reportedly working to co-develop shoes with sensors that monitor users’ movement and weight, according to CNBC, Verily is expanding its portfolio of connected devices for health monitoring and management. The company already has a watch that monitors certain patient data — including an FDA approved electrocardiogram — and is developing technologies to track diabetes-related eye disease in patients alongside smart lenses for cataract recovery.

It’s part of a broader push from technology companies to tie themselves closer to consumer health as they look to seize a part of the nearly $3 trillion healthcare industry.

If more data can be collected from wearable devices (or consumer behavior) and then monitored in a consistent fashion, tech companies ideally could suggest interventions faster and provide lower cost treatments to help avoid the need for urgent or emergency care.

These “top of the funnel” communications and monitoring services from tech companies could conceivably divert users and future healthcare patients into an alternative system that is potentially lower-cost with more of a focus on outcomes than on the volume of care and number of treatments prescribed.

Not all physicians are convinced that the use of persistent monitoring will result in better care. Dr. John Ioannidis, a celebrated professor from Stanford University, is skeptical about the utility of monitoring without a better understanding of what the data actually reveals.

“Information is good for you provided you know what it means. For much of that information we have no clue what it means. We have absolutely no idea what to do with it other than creating more anxiety,” Dr. Ioannidis said

The goal is to provide personalized guidance where machine learning can be used to identify problems and come up in concert with established therapeutic practices, according to investors who back life sciences starups.

“I think startups like Omada, Livongo, Lark, Vida, Virta, and others, can work and are already working on this overall vision of combining real time and personal historical data to deliver personalized guidance. But to be successful, startups need to be more narrowly focused and deliver improved outcomes and financial benefits right away,” according to Yap.

 

Japan’s “Society 5.0” initiative is a roadmap for today’s entrepreneurs

Japan, still suffering the consequences of its ‘Lost Decade’ of economic stagnation, is eyeing a transformation more radical than any the industrialized world has ever seen.

Boldly identified as “Society 5.0” Japan describes its initiative as a purposeful effort to create a new social contract and economic model by fully incorporating the technological innovations of the fourth industrial revolution. It envisions embedding these innovations into every corner of its ageing society. Underpinning this effort is a mandate for sustainability, bound tightly to the new United Nations global goals, the SDG’s. Japan wants to create, in its own words, a ‘super-smart’ society, and one that will serve as a roadmap for the rest of the world.

Japan hosts its first ever G20 summit in 2019 and this grand initiative will be on the agenda at the official B20 (Business 20) summit headed by the chairman of Hitachi .

Components of Society 5.0 and its implications for the US

Society 5.0 addresses a number of key pillars: infrastructure, finance tech, healthcare, logistics, and of course AI. The markets being grown in Japan are impressive. In robotics they predict $87 billion in investments and the IoT market is poised to hit $6 Billion in 2019

This means we are behind. We have not put enough focus on what AI can do not only for industry, but what it can do to move society forward and solve many of our most pervasive problems.

It isn’t just a problem of lack of investment by the United States government. Just this past September the Department of Defense announced a commitment of  $2 billion over the next five years toward new programs advancing artificial intelligence. This issue lies in the lack of a complete partnership between the United States Government and the private sector. But, why is Japan in the lead?

Full Fledged Embrace of AI and Cutting Edge Technology

Along with $1.44 billion from the government for AI funding, the Innovation Network Corp. of Japan is reorganizing to focus on AI and big data. They are projected to grow to $4 billion and operate to at least 2034. Much like in Britain and France, the government has made it a point to team with the private sector to move all of society forward.

Fresh Ideas to address Persistent Societal Problems

Along with the governmental and private partnership, Society 5.0 harnesses AI to address problems that continue to plague society. They are looking at how AI can help with the trappings of an aging population, pollution, and most importantly, how create such a sweeping initiate that is also agile enough to adjust to constant change of society everyday.

The goal of the work being done at Hitachi now on Society 5.0 is to create a Human-Centered Society. Technologies and innovations need to be leveraged to aid humans and our advancement, not to replace us in anyway.

How do American Technologists Close the Gap and partner with Japan?

First, in Silicon valley and beyond, American technologists and entrepreneurs must create a partnership between themselves and the U.S. government. Only when working together can we reach our full potential.

Take the British government as a model. This past April they announced a that it had put together “an AI deal worth more than £1 billion” that includes public and private funding.

France sees the opportunity and is betting on AI as well. This past spring President Emmanuel Macron announced an AI plan that includes $1.6 billion in funding, new research centers, data-sharing initiatives. The road has been clearly mapped for the U.S., just follow the path.

Next, American technologists and entrepreneurs must focus on certain industries and their ability to improve society in its entirety. There are 4 major industries technologists and entrepreneurs can focus on, and disrupt by modeling Japan’s Society 5.0 ideas and approach.

Healthcare

Japan’s society is more heavily weighted towards people over 60 than the rest of the world. In turn, more healthcare is needed to support people for a longer period of time as people live longer.

American technologists and entrepreneurs can capitalize by investing in and developing cognitive AI technologies that will greatly lessen the time needed to complete administrative tasks to allowing medical professionals to concentrate more on actually providing healthcare.

A UK  report suggests approximately 10% of NHS operational expenses could be saved through AI and automation. If this can be mirrored and then improved in the US the rising cost of healthcare, and declining public health can be tackled simultaneously.

Mobility

While the population in urban centers is growing, rural areas are being left with diminished access to everyday needs like, transportation, stores, hospitals, and community centers.
Continue to invest and develop autonomous vehicles, drones and single-driver cargo truck convoys. Access to basic everyday needs will not be a given for those residing far from urban centers. Here lies another dual opportunity for technologists and entrepreneurs, service those in need while simultaneously moving tech and society forward.

Infrastructure

28 percent of major U.S. roads are rated “poor” or in need of a complete rebuild. AI and other technologies such as robots, drones, sensors and IoT will help solve these problems. How? If only 10 percent of cars in the  U.S. became self-driving, those 26 million vehicles would generate 38.4 zettabytes of data annually.  In one year that would create over eight times the volume of the world’s current data.

Not only must we increase investment in autonomous vehicles, but we must make a concerted effort to leverage the data they will produce. Technologists and entrepreneurs will have an unprecedented advantage to leverage this data to predict everything from needs of infrastructure improvements to all bridges and roads being used by the autonomous vehicles. Companies like Hitachi are the ones you should look to work with. They’re doing amazing things in infrastructure today. How can this be translated to the U.S.? That is a question for you to ask and ultimately solve.

Mass transit is far ahead in Japan as well. Japan’s maglev train set a world record speed of 375 mph. With vast expanses of the United States landscape, and the ever growing challenges of flying, the rail transport industry is ripe for the picking. Plans for the midwest and the west coast have seem to come and go. What will be the plan that actually works?

Fintech

Blockchain is a  solution that will advance security, transparency and fraud prevention in society. Cognitive AI is producing results towards the goals of Society 5.0, ether it be a cashless society or a consumer focused one. Voice prompted AI assistants are currently providing consumer support by depositing money, performing trades, mastering trading platforms, networking, and onboarding of customers. This Omni-channel integration will result in finance and banking evolving to grow around customers needs. With this evolution we will see far less needs for cash and brick and mortar banks.

In the end, data alone is just code without meaning to its user. But, when technologists and entrepreneurs implement AI to its max potential a true difference will be seen. In Society 5.0, humanity and machines will solve the greatest issues society faces in the 21st century. We must embrace what Japan is creating with Society 5.0, or we will simply become a vestige of the technological past.

 

Aiming to change the way people take medicine, Lyndra Therapeutics raises $55 million

A little over two years after Lyndra Therapeutics Inc. first unveiled its technology for time-delayed drug delivery through a simple pill, the company has raised $55 million to continue developing the technology for public consumption.

By creating a new kind of ultra long-acting drug delivery mechanism in pills, the company claims it can remove the need for patients to follow strict guidelines for taking their medication.

Following doctors’ prescriptions for medication is a problem in emerging markets and among elderly patients and the new technology has implications for treating pretty much everything.

Developed in the Massachusetts Institute of Technology laboratory of Dr. Robert Langer, Lyndra was co-founded by Langer and Amy Schulman, a former lawyer for the pharmaceutical industry and a partner recruited to run the LS Polaris Innovation fund established by Polaris Partners in 2014 to invest in healthcare companies.

Polaris led the company’s most recent round of financing, which also included new investors like the Chinese private equity giant HOPU Investments, Gilead Sciences, Invus, Orient Life and the Bill & Melinda Gates Foundation (which initially provided funding for Dr. Langer’s research out of MIT).

Lyndra has raised the money as it continues along the path toward developing a pill to treat schizophrenia. Phase II trials for the pill, which are required before it can be approved by U.S. regulators are expected to begin next year. The company said it will also be developing other drug candidates that are developed internally and through partnerships to market over the coming years.

“Lyndra’s long-acting therapies have the potential to address a diversity of disease states,” said Robert Langer, co-founder and Board Member of Lyndra Therapeutics. “The ability to move from daily to weekly administration of an oral drug is groundbreaking. I believe Lyndra’s long-acting oral pill will be truly transformative.”

For investors like the Gates Foundation it was the company’s early work around anti-malarial drugs and HIV that likely attracted attention.

When the company first unveiled its technology back in 2016 publications like The Guardian hailed it as a breakthrough in drug delivery.

The technology depends in part on the novel structure of the pill itself. Encapsulated within a digestible pill is a star-shaped structure that has six arms folded in on itself. As stomach acid dissolves the casing for the pill the arms unfold and release their payload over time. As the star unfolds it expands in size so it can remain in the stomach rather than being pushed down the digestive tract. Eventually the arms break off and the remaining pieces of the pil are naturally expelled — like undigested food.

“People around the world depend on medications that require taking a pill every single day or even multiple times a day,” said Amy Schulman, a co-founder of Lyndra and its CEO, when the technology was first unveiled. “That approximately 50% of patients in the developed world do not take their medicines as prescribed, a statistic that is even more challenging in the developing world, has a demonstrable effect on healthcare outcomes and a cost estimates to the US healthcare system alone of over $100 billion annually. Lyndra’s long acting technology should make a real dent in this protracted problem and help change the lives of millions of patients who feel tethered to the daily pill.”

Lack of transparency in healthcare startups risks another Theranos implosion

Are more Theranos -style scandals looming for investors in healthcare startups?

A team of researchers associated with the Meta Research Innovation Center at Stanford thinks so. They’ve  published a paper warning investors in life sciences startups that a systemic lack of transparency exists in their portfolio companies — creating the possibility for more multi-billion dollar implosions and scandals like the one that toppled Theranos and its charismatic founder, Elizabeth Holmes.

Indeed, one of the study’s authors, Dr. John Ioannidis, the co-director of the Meta-Research Innovation Center at Stanford and director of the University’s PhD program in Epidemiology and Clinical Research, was  among the first people to identify the risks associated with Theranos and its “stealth research”.

Now Dr. Ioannidis and his co-authors, Ioana A. Cristea and Eli M. Cahan have published a study surveying the publicly available research from the largest privately held companies in the healthcare space, and found them lacking. 

Most of the highest valued startups in healthcare have not published any significant scientific literature, the study found. Nearly half of the publications from companies worth over $1 billion came from only two startups — 23andMe and Adaptive Biotechnologies, according to the paper.

“Many years ago I was the first person to say that Theranos had a problem,” says Ioannidis. “The problem that I had then was that Theranos did not have any peer-reviewed evidence to show.”

In an interview and in their paper, Ioannidis and Cahan warn that investors have overlooked systemic problems created by the lack of transparency among healthcare startups by

They write:

“It would be tempting to dismiss the Theranos case as just one rotten apple. However, we worry that the focus on fraud puts aside a more fundamental concern. Fraud is making waves in the news, but stealth research may have a more detrimental impact.”

According to the study’s findings, more than half of the healthcare startups that are worth more than $1 billion have published no highly cited papers at all. For companies that were acquired or are publicly traded that number is around 40%.

In all, healthcare startups that are currently valued at over $1 billion published 425 Pubmed papers. And of those papers only 34 (8%, including 2 reviews) were highly cited. For companies with valuations of over $1 billion who had been acquired or are publicly traded on stock exchanges, the researchers counted 413 papers, of which 47 (11%, including 9 reviews) were highly-cited.

Digging deeper into some of the companies which had high valuations but little or no published research revealed scores of operational and technological issues for the researchers.

For instance, StemCentrx, which was bought for $10.2 billion in 2016 by AbbVie, had published 16 papers — and only one highly-cited paper. Since the acquisition, the Food and Drug Administration had imposed a delay on the readout of the company’s phase II trial for its Rova T targeted antibody drug for cancer treatment. In December a Phase III trial for Rova T as a second-line treatment for patients with advanced small cell lung cancer was halted, because the treatment wasn’t working, according to a report in Targeted Oncology

Acerta Pharma, another healthcare focused startup focused on cancer treatments was bought by AstraZeneca for $7.3 billion. That company published nine articles and had one highly-cited paper for a very early study of a potential treatment for relapsed chronic lymphocytic leukemia. Acerta received accelerated approval for a drug called acalabrutinib, which treats a rare form of lymphoma called mantle cell lymphoma. Two years ago, AstraZeneca had to retract data and admit that Acerta falsified preclinical data for its drug.

Then there’s Intarcia, the developer of a device for diabetes treatment that’s worth $5.5 billion. That company had its device rejected by the FDA and was forced to lay off staff and halt a couple of later stage trials. It had only published six papers — none of them very highly cited.

Ultimately, the researchers concluded that highly valued healthcare startups don’t contribute to published research and that the valuation of these companies by investors is divorced from any externally validated data.

For the researchers (and for investors) this should presents a problem.

“Many unicorns may be overvalued [21] and subject to unrealistic scientific expectations,” the study’s authors write. And they reject the argument that simply applying for — and receiving — patents is enough to prove that a technology in the healthcare space has been thoroughly vetted. “[Patents] do not offer the same level of documentation as peer-reviewed articles. For example, Theranos had over 100 patents [1], but these were unable to supplant the vacuum in their evidence,” the researchers wrote. 

Even if companies want to protect their technology, there are still ways for them to be more transparent about the results or benefits of their technology. The authors acknowledge that publishing isn’t the primary mission of startups. They can, however publish a few high-value articles, secure their technology through patents and then work with researchers, universities or hospitals to validate the technology and have those organizations publish results of the tests, the authors argue.

As the authors conclude:

Start-ups are key purveyors of innovation and disruption. Consequently, holding them to a minimal standard of evaluation from the scientific community is crucial. Participation in peer review, with all its limitations, is the best way we have to uphold this standard. We are not arguing that start-ups should divert excessive resources to having peer-reviewed papers. However, when their products are destined to affect patient health, they should neither be solely doing marketing. Confidential data sharing with potential investors or regulators cannot replace more open scrutiny by the scientific community.

 

The Pill Club raises $51M as VCs find new opportunities in women’s health

Through telemedicine and direct-to-consumer sales platforms, startups are streamlining the historically arduous process of accessing contraception.

The latest effort to secure a significant financing round is The Pill Club, an online birth control prescription and delivery service. Consumer-focused investor VMG Partners has led its $51 million Series B, with participation from new investors GV and ACME Capital (formerly known as Sherpa Capital), and existing investors Base10 Partners and Shasta Ventures. The Pill Club declined to disclose its valuation.

Launched in 2016 in San Carlos, California, The Pill Club couples healthcare services with at-home delivery, reaching customers in all 50 states. With a team of doctors, nurses and patient care coordinators, the startup operates its own pharmacy and is licensed to prescribe medication in 35 states. With the new funding, which brings its total raised to $67 million, founder and chief executive officer Nick Chang said he plans to scale the business 50 percent and expand its prescription service across the entire U.S.

“At the end of the day, our company is about empowering women,” Chang told TechCrunch. “What does that mean? It means empowering our patients to make their own healthcare decisions and making reproductive healthcare more common — something to not be shy about or worried about.”

Chang, who has spent his career in medicine and holds an M.D. from Duke University, previously founded Ganogen. The business, which sought to facilitate patient’s access to organ donors, ultimately shut down but was a catalyst to The Pill Club’s formation, as were experiences from Chang’s youth.

“I [grew] up with an older sister who was on birth control since she was 14 for menstrual regulation,” Chang said. “She really felt embarrassed to pick up the medication and to talk to anyone about it and that was really insightful for me. There are so many hurdles in accessing birth control besides clinics being around.”

Some 67 million women between the ages of 13 to 44 live in the U.S.; 19 million of them live in contraceptive deserts, or areas that lack reasonable access to public clinics. The Pill Club wants to eliminate those deserts, as do other companies in the digital health arena.

Digital health has remained one of the hottest destinations for VC investment. In 2018, investors put about $4.5 billion into U.S. companies in the sector, a 17 percent increase year-over-year, according to PitchBook data. Telemedicine startups garnered a record $1.25 billion in funding in that timeframe thanks to large financings for industry leader Oscar, a health insurance startup that raised $540 million in 2018 alone; as well as an $88 million Series A for newcomer Roman, which offers a cloud pharmacy for erectile dysfunction.

Startups focused on women’s health, meanwhile, have continued to garner more attention from VCs. These companies, including The Pill Club and comepetitor Nurx, have not only benefited from the rapid rise of telehealth, but also from a societal shift sparked in part by President Donald Trump and Republican lawmakers’ attempts to limit women’s access to birth control.

“People want to talk about this,” Chang said. “With so much happening from Hollywood to politics … it’s really got some people to say ‘ok, we really need to talk about what we are prioritizing as a society.'”

In addition to accelerating the expansion of its 260-person team, The Pill Club plans to use the investment to explore launching more services within women’s healthcare and to broaden the educational content it offers its customers.

“This is just the beginning of a much broader and bigger movement,” Chang said.

The Pill Club raises $51M as VCs find new opportunities in women’s health

Through telemedicine and direct-to-consumer sales platforms, startups are streamlining the historically arduous process of accessing contraception.

The latest effort to secure a significant financing round is The Pill Club, an online birth control prescription and delivery service. Consumer-focused investor VMG Partners has led its $51 million Series B, with participation from new investors GV and ACME Capital (formerly known as Sherpa Capital), and existing investors Base10 Partners and Shasta Ventures. The Pill Club declined to disclose its valuation.

Launched in 2016 in San Carlos, California, The Pill Club couples healthcare services with at-home delivery, reaching customers in all 50 states. With a team of doctors, nurses and patient care coordinators, the startup operates its own pharmacy and is licensed to prescribe medication in 35 states. With the new funding, which brings its total raised to $67 million, founder and chief executive officer Nick Chang said he plans to scale the business 50 percent and expand its prescription service across the entire U.S.

“At the end of the day, our company is about empowering women,” Chang told TechCrunch. “What does that mean? It means empowering our patients to make their own healthcare decisions and making reproductive healthcare more common — something to not be shy about or worried about.”

Chang, who has spent his career in medicine and holds an M.D. from Duke University, previously founded Ganogen. The business, which sought to facilitate patient’s access to organ donors, ultimately shut down but was a catalyst to The Pill Club’s formation, as were experiences from Chang’s youth.

“I [grew] up with an older sister who was on birth control since she was 14 for menstrual regulation,” Chang said. “She really felt embarrassed to pick up the medication and to talk to anyone about it and that was really insightful for me. There are so many hurdles in accessing birth control besides clinics being around.”

Some 67 million women between the ages of 13 to 44 live in the U.S.; 19 million of them live in contraceptive deserts, or areas that lack reasonable access to public clinics. The Pill Club wants to eliminate those deserts, as do other companies in the digital health arena.

Digital health has remained one of the hottest destinations for VC investment. In 2018, investors put about $4.5 billion into U.S. companies in the sector, a 17 percent increase year-over-year, according to PitchBook data. Telemedicine startups garnered a record $1.25 billion in funding in that timeframe thanks to large financings for industry leader Oscar, a health insurance startup that raised $540 million in 2018 alone; as well as an $88 million Series A for newcomer Roman, which offers a cloud pharmacy for erectile dysfunction.

Startups focused on women’s health, meanwhile, have continued to garner more attention from VCs. These companies, including The Pill Club and comepetitor Nurx, have not only benefited from the rapid rise of telehealth, but also from a societal shift sparked in part by President Donald Trump and Republican lawmakers’ attempts to limit women’s access to birth control.

“People want to talk about this,” Chang said. “With so much happening from Hollywood to politics … it’s really got some people to say ‘ok, we really need to talk about what we are prioritizing as a society.'”

In addition to accelerating the expansion of its 260-person team, The Pill Club plans to use the investment to explore launching more services within women’s healthcare and to broaden the educational content it offers its customers.

“This is just the beginning of a much broader and bigger movement,” Chang said.

Veteran Googler heads to Lyft to lead 1,000-plus person engineering team

Eisar Lipkovitz, a veteran Google executive who most recently led the video and display advertising team there, is leaving the company to head up engineering efforts at Lyft .

As executive vice president of engineering, Lipkovitz will be leading Lyft’s engineering team, which now eclipses 1,000 people.

Eisar’s hiring comes on the heels of massive growth at Lyft, specifically its engineering team. The ride-hailing company’s engineering team, doubled in size in the last year. It also follows the hiring of another Google engineering veteran Manish Gupta, who joined Lyft in August as vice president of engineering to build out the ride-hailing company’s business platforms, including enterprise, partnerships and healthcare.

Gupta will report to Eisar.

“It’s clear that Lyft is tackling one of the most interesting and world-changing engineering challenges of our lifetime, and the team has done an exceptional job innovating through dispatch, matching, pricing, and mapping to create the overall experience.” Eisar said. “The work Lyft is doing intersects with my passion of operating extremely complex systems efficiently while developing strong leaders in tech, and I couldn’t be more excited to join the team.”

Eisar will report directly to Logan Green, Lyft’s co-founder and CEO. Luc Vincent, who is vice president of Lyft’s autonomous vehicle technology program, operates separately.

During Eisar’s 15 years at Google, he led the team that built Google display, video and apps advertising products. He previously worked on the infrastructure behind Google Search. He also worked at Akamai.

Lyft has aggressively ramped up its staff and coverage in the U.S. over the past two years. And it’s paid off. The company’s ride-hailing app has more than 96 percent coverage in the U.S. and 35 percent market share.

It has also expanded Lyft Business, the company’s enterprise unit, through partnerships with organizations and companies like Starbucks, LAX,  Allstate, Hewlett Packard Enterprise, JetBlue, Delta and Blue Cross Blue Shield, as well as rolled out various other products such as a monthly subscription plan called Lyft’s All-Access.