Precise.ly, the new genomics startup launched by 23andMe co-founder Linda Avey and Aneil Mallavarapu, is taking its spin on direct to consumer personalized genomics to India through a partnership with Naryana Health, one of India’s leading specialty hospital networks.
Narayana, a company that operates a network of 24 hospitals serving 2.5 million patients, is one of the most fascinating stories in healthcare. By emphasizing efficiencies and cost savings, the hospital network has managed to bring costs down dramatically for many procedures — including providing cancer surgeries for as little as $700 and heart bypass surgeries for $3,000 (as this fascinating article in Bloomberg BusinessWeek illustrates).
Precise.ly’s mission — to collect and analyze genetic data from populations that typically haven’t had access to the services — is one that resonates in a world where the majority of research has been conducted on wealthier populations in wealthy countries. Other startups, like 54Gene, are trying to bring a similar message to the African continent.
“To date, most human genetics research has focused on European populations. But genetic insights need to be tuned to the rest of the world,” said Mallavarapu, in a statement. “We’ve assembled a team of experts who are pioneering advances in genetic analysis and its application to the huge populations of people in south Asia and beyond.”
Some of that work is being done in concert with Narayana health, the hospital network founded by Dr. Devi Prasad Shetty nearly twenty years ago. Dr. Shetty is initially hoping that Precise.ly’s genetic database will be able to help his hospitals build out a stem cell donor registry that could help hundreds of thousands of Indians who need transplants.
“Personal genetic testing is recognized by the U.S. FDA to test genetic risk for Parkinsonism, late onset Alzheimer’s disease and celiac disease. It is only a matter of time before most diseases get added to the list,” Dr. Shetty said in a statement. “Because of the simplicity of genetic testing from saliva samples, it’s possible to conduct large-scale population screening at a reasonable cost. We are working with Precise.ly’s team of researchers to add HLA typing, which has the potential to transform cancer and other disease treatments in India.”
The path to entering the Indian market was slightly circuitous for Precise.ly. When Avey first left 23andMe, she went to RockHealth (an investor in the company’s $1 million seed round), and began exploring ways to organize and store more of a patient’s quantified health data.
As that company failed to gain traction, Avey took another look at the genetics market and found that there were significant opportunities in underserved markets — and that India, with its rising middle class and burgeoning healthcare industry would be a good target.
“We decided we would build on this Helix platform all kinds of apps for people who had specific diagnosis,” says Avey. But the market was already chock full of startups (including 23andMe), so an early investor in the company from, Civilization Ventures, and its founder Shahram Seyedin-Noor suggested that they begin to look globally for growth.
“Precise.ly’s mission is to deliver validated genetic insights to the billions of people living outside the western world. We’re initially focused on India where there are urgent health issues readily addressable through access to personal genomic data,” said Avey, the chief executive officer of Precise.ly, in a statement. “Our partnership with Narayana is vital to delivering on the promise of precise, data-driven health.”
After last year’s stellar turn out of almost 1,000 Silicon Valley shakers and movers at our inaugural Winter Party, TechCrunch is returning with the 3rd Annual Winter Party in San Francisco on February 7.
The party will feature tasty cocktails and canapés, party games and activities, plenty of photo ops, giveaways and some fun surprises. As you network your way across the sea of attendees, you’ll also get to check-out a handful of promising early-stage startups just waiting for their big break.
The shindig will be held in the multi-level facility at Galvanize in San Francisco on Friday, February 7. While the venue is large, it won’t be able to hold all of Silicon Valley, so tickets are very limited and will be released on a rolling basis for $85 each. If you’re a startup and want to demo your product at this event, demo tables are available for purchase at $1,500 each. Demo tickets are limited too, so get yours before we sell out!
More about the Winter Party:
When? Friday, February 7, 6:00 p.m. – 9:00 p.m.
Where? Galvanize, 44 Tehama St., San Francisco, CA 94105
How? Get tickets here for just $85 each. There are only a limited number of tickets for this event. Tickets will be released in batches, so if you don’t see any availability, stay tuned to TechCrunch for our next release (following us on Facebook or Twitter works great), as they sell out quickly. TechCrunch parties have a history of being the place you want to meet your future investor, acquirer or co-founder. And to top it all off, we’re going to give away some really great door prizes, like TC swag and tickets to Disrupt SF.
Hope to see you all there!
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Extra Crunch is excited to announce the launch of “Dear Sophie,” an advice column with answers for all your questions on attracting, hiring and retaining immigrant employees — and more.
Dear Sophie is a collaborative forum hosted by Extra Crunch and curated by Sophie Alcorn, who is certified as a specialist attorney in immigration and nationality law by the State Bar of California Board of Legal Specialization. Sophie is the founder of Alcorn Immigration Law, the fastest-growing immigration law firm in Silicon Valley and 2019 Global Law Experts Awards’ “Law Firm of the Year in California for Entrepreneur Immigration Services.”
As I pack my bags to speak at TechCrunch Disrupt in Berlin this week, I’m happy to announce the first edition of my new column, Dear Sophie. I’m excited to answer your questions about U.S. immigration!
And, If you’re in the area, I invite you to join me at Disrupt Berlin 2019. You can use promo code ALCORN for discounted admission and meet me in person for a free consultation with CrunchMatch, or attend one of my two sessions:
Hope to see you there,
Dear Sophie: I’m scared: I feel like I should really be in Silicon Valley to grow my company, but everything I read about immigration makes it sound so hard. Is my dream possible? — Dreaming in Dresden
Dear Dreaming: Yes, coming to the U.S. to build a startup is absolutely possible. In fact, I see founders like you do it all the time. Your dream is valid and definitely worth pursuing.
The first piece of advice I’d give you is to be careful about which news sources you trust! You might not be getting the whole story. While dramatic changes are taking place in the United States, we still have a functioning immigration system that allows people to come live and work here — people just like you.
The second piece of advice I have is to research the many visa and green card options that can allow you to come to the United States and grow your company (you can read about them on my blog). You’ll find that some visas grant you the ability to work for the short-term or the long-term (potentially), and some allow you to visit and see what things are like here.
With these visas, you can find a co-founder and build the early stage of your company, establish a U.S. branch of your existing business, seek venture capital and so much more.
The third piece of advice I have is to really clarify why you want to come to America — that way, you can be strategic about achieving your goals. You might require a little guidance here, which is one example of where immigration lawyers like myself can be helpful.
When I meet people in your situation, I reassure them that, not only are they safe to dream with me, but I’ve also helped hundreds of people just like them realize their dreams, even when they didn’t believe it was possible. Almost everybody who comes here once asked the same questions you’re asking.
My last piece of advice is simply to follow your heart. The world needs your ideas and contributions. There are lots of resources and ways to get informed and educated, which is the first step on this journey. Once you have a clear vision, you can work to make your dream a reality — It’s not always easy, but where there’s a will, there’s a way.
You’ve already asked for help, which is a great way to get started. I wish you the best!
Dear Sophie: I have a startup that has been quite successful in Germany. What’s the best way for me to spend some time in the United States exploring product-market fit, gauging business development, and talking to venture capitalists? — Founder in Frankfurt
Dear Founder: Congratulations on your startup! And bravo for considering taking steps toward strengthening the U.S. marketplace.
The first thing I suggest you decide is how long it will likely take for you to accomplish your goals.
If you think you can get the answers you need in less than 90 days, the answer is pretty simple: apply for ESTA (Electronic System for Travel Authorization), which is available to citizens of about 40 countries (including Germany). You’re allowed to visit for business or pleasure with ESTA, but you’re not allowed to work — and you must definitely depart the United States before the end of the authorized period.
ESTA could be great for a short business trip or a brief accelerator program in Silicon Valley. Be careful with programs that run longer than 90 days. I’ve seen founders in these longer programs leave on day 88 to go back home for a week and then return to the U.S. to complete the program, hoping that this is a safe workaround of the time limit. Remember that ESTA is a non-immigrant status, and if Customs and Border Protection suspects that you are trying to live here or work here, they have the authority to deny your entry to the United States.
On the other hand, if you know you’ll need to spend 4-6 months in the U.S. without interruption, I suggest you talk to an attorney about the possibility of applying for a B-1/B-2 visitor visa (even if you have ESTA). A visitor visa allows you to stay in the U.S. for up to six months on a single visit.
People often ask me how long they can stay in the U.S. during a calendar year or how long they need to be outside of the United States after a six-month visit. While there is no fixed answer to these questions, I remind them that ESTA, B-1, and B-2 are non-immigrant statuses, Customs and Border Protection has the authority to deny you entry if you appear to be living or working in the U.S. In my experience, reentry seems OK when people are spending less than 50% of the time in the country as visitors. Still, it’s always best to talk with an attorney about your particular situation. For example, sometimes our clients request that we provide them with letters of support explaining why their trip is temporary, which they can show to the officers at the airport if they get questioned.
I encourage people in your situation to at least come for 90 days. It’s a great opportunity to network, have some great conversations, and clarify your long-term goals in the U.S. Take some time to think about it, reach out online, so you have things set up before you arrive, and plan out your finances so you can make the most of your trip. I’m wishing you every success!
Dear Sophie: I am a venture capitalist, and my fund recently had great success. We’re now raising a second round and building out the infrastructure of our organization. I have a brilliant contractor working for me who scouts new startups. She was born in India, just got her Bachelor’s degree in Computer Science from an Ivy League university, and was also recently accepted back into a Master’s program there. I want to help her plan for her future. Can she keep working for me after OPT, or should she go back to school? How do these choices affect her prospects for short-term and long-term chances for immigration? — Venture in Venice Beach
A little over a year after the dissolution of the once high-flying blood testing startup Theranos, another startup has raised over $27 million to breathe new life into the vision of bringing low-cost blood tests to point-of-care medical facilities.
Unlike Theranos, Truvian Sciences is not claiming that most of its blood tests do not need clearance from the U.S. Food and Drug Administration, and is, in fact, raising the money to proceed with a year-long process to refine its technology and submit it to the FDA for approval.
“More and more consumers are refusing to accept the status quo of healthcare and are saying no to expensive tests, inconvenient appointments and little to no access to their own test results,” said Jeff Hawkins, the president and chief executive of Truvian, in a statement. “In parallel, retail pharmacies are rising to fill demand, becoming affordable health access points. By bringing accurate, on-site blood testing to convenient sites, we will give consumers a more seamless experience and enable them to act on the vast medical insights that come with regular blood tests.”
Hawkins, the former vice president and general manager of reproductive and genetic health business at Illumina, is joined by a seasoned executive team of life sciences professionals including Dr. Dena Marrinucci, the former co-founder of Epic Sciences, who serves as the company’s senior vice president of corporate development and is a co-founder of the company.
Image courtesy of Flickr/Mate Marschalko
As part of today’s announcement, the company said it was adding Katherine Atkinson, a former executive at Epic Sciences and Illumina, as its new chief commercial officer, and has brought on the former chairman of the Thermo Fisher Scientific board of directors, Paul Meister, as a new director.
The ultimate goal, according to Hawkins, is to develop a system that can be installed in labs and can provide accurate results in 20 minutes for a battery of health tests from a small sample of blood for as low as $50. Typically, these tests can cost anywhere from several hundred to several thousand dollars — depending on the testing facility, says Hawkins.
Using new automation and sensing technologies, Truvian is aiming to combine chemistries, immunoassays and hematology assays into a single device that can perform standard assessment blood tests like lipid panels, metabolic panels, blood cell counts, and tests of thyroid, kidney and liver functions.
The company’s system includes remote monitoring and serviceability, according to a statement from Truvian. Its dry reagent technology allows materials to be stored at room temperature, removing the need for cold chain or refrigerated storage. According to a statement, the company is working to receive a CE Mark in the European Economic Area and submitted to the FDA for 510(k) clearance along with a “clinical laboratory improvement amendments” waiver application to let the devices be used in a retail setting or doctor’s office.
“We don’t believe that single drop of blood from a finger stick can do everything,” says Hawkins (in opposition to Theranos). “Fundamentally as a company we have built the company with seasoned healthcare leaders.”
As the company brings its testing technology to market, it’s also looking to compliment the diagnostics toolkit with a consumer-facing app that would provide a direct line of communication between the company and the patients receiving the results of its tests.
Truvian’s data will integrate with both Apple and Google’s health apps as well as reside on the company’s own consumer-facing app, according to Hawkins.
“At the end of the day precision medicine is going to come from integrating these data sources,” says Hawkins. “I think if we pull off what we want we should be able to make your routine blood testing far more accessible.”
Flying cars are fine – but why use a car when you can have a motorcycle instead? YC-backed startup JetPack Aviation wants to answer that question with the world’s first flying motorcycle, a personal aircraft dubbed ‘The Speeder,’ a name that Star Wars fans will surely appreciate. Now, JetPack has raised a seed round of $2 million from investors indulging Draper Associates, Skype co-founder Jaan Tallinn, YC, Catheis Ventures and a group of angels that it says will fund the development of the Speeder’s first functional prototype.
Back in March, JetPack revealed its plans for the Speeder, which it says will provide a fully stabilized ride that’s either pilot-controlled or fully autonomous. It can take off and land vertically, and reach top speeds of potentially over 400 MPH. There are not exposed rotors systems, which make it a lot safer and easier to operate than a lot of other VTOL designs and helicopters, and the company says it can also be refuelled in under 5 minutes, which is a dramatically shorter turn around time for powering up vs. an electric vehicle.
This isn’t JetPack’s first aerial rodeo: The company, led by CEO and founder David Mayman, has already created an actual jet pack. Mayman himself has demonstrated the personal aerial jet pack numerous times, and it’s been certified by the FAA, plus it landed a CARADA agreement with the U.S. Navy Special Forces for use in short-distance troop transportation. The jet pack also boasts a lot of features that sound, on paper, like diene fiction: Over 100 mph top seed, and suitcase-sized portability, for instance.
That track record is why when Mayman tells me this $2 million round “should fully fund the first full scale flying prototype, including all modelling designs and build,” I tend to believe him more than I would just about anyone else in the world making a similar claim.
Part of the reason the Speeder is more viable near-term than other VTOL designs is that it will rely on turbine propulsion, rather than battery-based flight systems. This is because, in Mayman’s opinion, “current battery energy density is just too low for most electrically powered VTOLs to be truly practical,” and that timelines optimistically for that to change are in the 5 to 10 year range. The Speeder, by comparison, should feasibly be able to provide quick cargo transportation for emergency services and military (its first planned uses before moving on to the consumer market) in a much shorter period.
If the numbers around the size of the market are a moving target, just think about how to gauge the validity and efficacy of the products that are behind all of those billions of dollars in spending.
Andy Coravos, the co-founder of Elektra Labs, certainly has.
Coravos, whose parents were a dentist and a nurse practitioner, has been thinking about healthcare for a long time. After a stint in private equity and consulting, she took a coding bootcamp and returned to the world she was raised in by taking an internship with the digital therapeutics company Akili Interactive.
Coravos always thought she wanted to be in healthcare, but there was one thing holding her back, she says. “I’m really bad with blood.”
That’s why digital therapeutics made sense. The stint at Akili led to a position at the U.S. Food and Drug Administration as an entrepreneur in residence, which led to the creation of Elektra Labs roughly two years ago.
Now the company is launching Atlas, which aims to catalog the biometric monitoring technologies that are flooding the consumer health market.
These monitoring technologies, and the applications layered on top of them, have profound implications for consumer health, but there’s been no single place to gauge how effective they are, or whether the suggestions they’re making about how their tools can be used are even valid. Atlas and Elektra are out to change that.
The FDA has been accelerating its clearances for software-driven products like the atrial fibrillation detection algorithm on the Apple Watch and the ActiGraph activity monitors. And big pharma companies like Roche, Pfizer and Novartis have been investing in these technologies to collect digital biomarker data and improve clinical trials.
Connected technologies could provide better care, but the technologies aren’t without risks. Specifically the accuracy of data and the potential for bias inherent in algorithms which were created using flawed datasets mean that there’s a lot of oversight that still needs to be done, and consumers and pharmaceutical companies need to have a source of easily accessible data about the industry.
”The increase in FDA clearances for digital health products coupled with heavy investment in technology has led to accelerated adoption of connected tools in both clinical trials and routine care. However, this adoption has not come without controversy,” said Coravos, co-founder and CEO of Elektra Labs, in a statement. “During my time as an Entrepreneur in Residence in the FDA’s Digital Health Unit, it became clear to me that like pharmacies which review, prepare, and dispense drug components, our healthcare system needs infrastructure to review, prepare, and dispense connected technologies components.
The analogy to a pharmacy isn’t an exact fit, because Elektra Labs currently doesn’t prepare or dispense any of the treatments that it reviews. But Atlas is clearly the first pillar that the digital therapeutics industry needs as it looks to supplant pharmaceuticals as treatments for some of the largest and most expensive chronic conditions (like diabetes).
Courtesy of Andrea Coravos/Elektra Labs
Coravos and here team interviewed more than 300 professionals as they built the Atlas toolkit for pharmaceutical companies and other healthcare stakeholders seeking a one-stop-shop for all of their digital healthcare data needs. Like a drug label, or nutrition label, Atlas publishes labels that highlight issues around the usability, validation, utility, security and data governance of a product.
In an article in Quartz earlier this year, Coravos made her pitch for Elektra Labs and the types of things it would monitor for the nascent digital therapeutics industry. It includes the ability to handle adverse events involving digital therapies by providing a single source where problems could be reported; a basic description for consumers of how the products work; an assessment of who should actually receive digital therapies, based on the assessment of how well certain digital products perform with certain users; a description of a digital therapy’s provenance and how it was developed; a database of the potential risks associated with the product; and a record of the product’s security and privacy features.
As the projections on market size show, the problem isn’t going to get any smaller. As Google’s recent acquisition bid for Fitbit and the company’s reported partnership with Ascension on “Project Nightingale” to collect and digitize more patient data shows, the intersection of technology and healthcare is a huge opportunity for technology companies.
“Google is investing more. Apple is investing more… More and more of these devices are getting FDA cleared and they’re becoming not just wellness tools but healthcare tools,” says Coravos of the explosion of digital devices pitching potential health and wellness benefits.
Elektra Labs is already working with undisclosed pharmaceutical companies to map out the digital therapeutic environment and identify companies that might be appropriate partners for clinical trials or acquisition targets in the digital market.
“The FDA is thinking about these digital technologies, but there were a lot of gaps,” says Coravos. And those gaps are what Elektra Labs is designed to fill.
At its core, the company is developing a catalog of the digital biomarkers that modern sensing technologies can track and how effective different products are at providing those measurements. The company is also on the lookout for peer-reviewed published research or any clinical trial data about how effective various digital products are.
Backing Coravos and her vision for the digital pharmacy of the future are venture capital investors including Maverick Ventures, Arkitekt Ventures, Boost VC, Founder Collective, Lux Capital, SV Angel, and Village Global.
Alongside several angel investors, including the founders and chief executives from companies including: PillPack, Flatiron Health, National Vision, Shippo, Revel and Verge Genomics, the venture investors pitched in for a total of $2.9 million in seed funding for Coravos’ latest venture.
“Timing seems right for what Elektra is building,” wrote Brandon Reeves, an investor at Lux Capital, which was . one of the first institutional investors in the company. “We have seen the zeitgeist around privacy data in applications on mobile phones and now starting to have the convo in the public domain about our most sensitive data (health).”
If the validation of efficacy is one key tenet of the Atlas platform, then security is the other big emphasis of the company’s digital therapeutic assessment. Indeed, Coravos believes that the two go hand-in-hand. As privacy issues proliferate across the internet, Coravos believes that the same troubles are exponentially compounded by internet-connected devices that are monitoring the most sensitive information that a person has — their own health records.
In an article for Wired, Koravos wrote:
Our healthcare system has strong protections for patients’ biospecimens, like blood or genomic data, but what about our digital specimens? Due to an increase in biometric surveillance from digital tools—which can recognize our face, gait, speech, and behavioral patterns—data rights and governance become critical. Terms of service that gain user consent one time, upon sign-up, are no longer sufficient. We need better social contracts that have informed consent baked into the products themselves and can be adjusted as user preferences change over time.
We need to ensure that the industry has strong ethical underpinning as it brings these monitoring and surveillance tools into the mainstream. Inspired by the Hippocratic Oath—a symbolic promise to provide care in the best interest of patients—a number of security researchers have drafted a new version for Connected Medical Devices.
With more effective regulations, increased commercial activity, and strong governance, software-driven medical products are poised to change healthcare delivery. At this rate, apps and algorithms have the opportunity to augment doctors and complement—or even replace—drugs sooner than we think.