Maryland and Montana have become the first U.S. states to pass laws that make it tougher for law enforcement to access DNA databases.
The new laws, which aim to safeguard the genetic privacy of millions of Americans, focus on consumer DNA databases, such as 23andMe, Ancestry, GEDmatch and FamilyTreeDNA, all of which let people upload their genetic information and use it to connect with distant relatives and trace their family tree. While popular — 23andMe has more than three million users, and GEDmatch more than one million — many are unaware that some of these platforms share genetic data with third parties, from the pharmaceutical industry and scientists to law enforcement agencies.
When used by law enforcement through a technique known as forensic genetic genealogy searching (FGGS), officers can upload DNA evidence found at a crime scene to make connections on possible suspects, the most famous example being the identification of the Golden State Killer in 2018. This saw investigators upload a DNA sample taken at the time of a 1980 murder linked to the serial killer into GEDmatch and subsequently identify distant relatives of the suspect — a critical breakthrough that led to the arrest of Joseph James DeAngelo.
While law enforcement agencies have seen success in using consumer DNA databases to aid with criminal investigations, privacy advocates have long warned of the dangers of these platforms. Not only can these DNA profiles help trace distant ancestors, but the vast troves of genetic data they hold can divulge a person’s propensity for various diseases, predict addiction and drug response, and even be used by companies to create images of what they think a person looks like.
Ancestry and 23andMe have kept their genetic databases closed to law enforcement without a warrant, GEDmatch (which was acquired by a crime scene DNA company in December 2019) and FamilyTreeDNA have previously shared their database with investigators.
To ensure the genetic privacy of the accused and their relatives, Maryland will, starting October 1, require law enforcement to get a judge’s sign-off before using genetic genealogy, and will limit its use to serious crimes like murder, kidnapping, and human trafficking. It also says that investigators can only use databases that explicitly tell users that their information could be used to investigate crimes.
In Montana, where the new rules are somewhat narrower, law enforcement would need a warrant before using a DNA database unless the users waived their rights to privacy.
The laws “demonstrate that people across the political spectrum find law enforcement use of consumer genetic data chilling, concerning and privacy-invasive,” said Natalie Ram, a law professor at the University of Maryland. “I hope to see more states embrace robust regulation of this law enforcement technique in the future.”
The introduction of these laws has also been roundly welcomed by privacy advocates, including the Electronic Frontier Foundation. Jennifer Lynch, surveillance litigation director at the EFF, described the restrictions as a “step in the right direction,” but called for more states — and the federal government — to crack down further on FGGS.
“Our genetic data is too sensitive and important to leave it up to the whims of private companies to protect it and the unbridled discretion of law enforcement to search it,” Lynch said.
“Companies like GEDmatch and FamilyTreeDNA have allowed and even encouraged law enforcement searches. Because of this, law enforcement officers are increasingly accessing these databases in criminal investigations across the country.”
A spokesperson for 23andMe told TechCrunch: “We fully support legislation that provides consumers with stronger privacy protections. In fact we are working on legislation in a number of states to increase consumer genetic privacy protections. Customer privacy and transparency are core principles that guide 23andMe’s approach to responding to legal requests and maintaining customer trust. We closely scrutinize all law enforcement and regulatory requests and we will only comply with court orders, subpoenas, search warrants or other requests that we determine are legally valid. To date we have not released any customer information to law enforcement.”
GEDmatch and FamilyTreeDNA, both of which opt users into law enforcement searches by default, told the New York Times that they have no plans to change their existing policies around user consent in response to the new regulation.
Ancestry did not immediately comment.
As people live longer and longer and have long-term health issues like cancer and dementia, caring for elderly relatives is becoming a huge societal and political issue. Right now this care is antiquated and run by incumbents, many of which still run off paper and Excel. We are now seeing a new wave of startups turn up to tackle this space by applying Apple’s age-old model of owning the experience end-to-end and running everything on a platform.
The latest to join this race is U.K. startup Lifted, which has now raised $6.2 million in a Series A funding round led by Fuel Ventures. Also participating were existing investor 1818 Venture Capital as well as new investors Novit Ventures, Perivoli Innovations, the J.B. Ugland family office and a number of angels. This latest funding round takes the total raised by Lifted to $11.2 million.
Lifted says its U.K. market is increasing and claims the number of people caring for adult loved ones has risen exponentially during the pandemic, with almost one in two people supporting people outside their household.
The startup is entering a perfect storm of increasing need, unpopular care homes and the U.K. government still without a long-term plan for social care.
In contrast to a raft of agencies and freelancers, Lifted directly employs its care workforce and uses its platform to “gamify and improve the experience of carers to make them perform better in people’s lives and also to restore respect to the caring profession” with its Care Management Platform, says the company.
Lifted has also acquired the “Live Better With Dementia” website and launched the Lifted Dementia Hub, an online community with a marketplace of products.
Rachael Crook co-founded Lifted with Sam Cohen. She says she was inspired to get into the sector when, at the age of 24, she had to care for her mother, who was diagnosed with dementia at age 56. “I was in that position much younger than most people. And it seemed abundantly clear to me that it was an experience that was hugely emotionally important to me, and financially expensive, was really convoluted and frustrating. It made an already really difficult time, more difficult. My mum brought me up to really fight for the underdog and I felt like the carers themselves were getting a really poor deal. And yet, it’s a huge colossal market. The care market is set to double in the next 20 years, and for the next 10 years, we will look to compete against traditional care companies. We want to transform the care experience. This is a product that is worth four and a half times your mortgage. And yet, it’s predominantly bought in a really antiquated way with paper and pen systems. It’s really hard to keep up to date with your loved ones’ care. We’re also competing against new entrants.”
She added: “In 12 months, we have tripled revenue, launched the first App in the world to offer free care advice, and cut Carer churn to half the industry average, all while maintaining exclusively 5-star reviews on Trustpilot.”
Mark Pearson, managing partner of Fuel Ventures said: “Rachael, Sam and their team have delivered exceptional growth in the past year. They have a unique vision of the future for care and their model is delivering clear results for both sides of the marketplace.”
Welcome back to the week, and welcome back to The Exchange. Robinhood has yet to file its IPO, so we’re looking at other companies in the meantime. Today it’s Babylon Health, a British healthtech company that is pursuing a U.S. listing via a blank-check company, or SPAC.
You have questions. I have questions. We’ll get to some answers.
But before we do, we wanted to note that Anna and I are looking into the AI startup market tomorrow morning. If you are a VC with notes regarding the current pace of investment into the sector or thoughts on where customer traction is highest, let us know. If you are a founder building an AI-powered startup, we’d also like to hear from you about what you are seeing. Use the subject line “AI startups,” please.
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With that out of the way, let’s get into Babylon Health. We’ll kick off with a short riff on its fundraising history, talk about its product, and then dive into its numbers and, bracing ourselves for impact, its projections.
The larger context this morning is that we’re doing legwork ahead of what could be a super active Q3 2021 IPO cycle. Kanzhun, a Chinese company, has also filed for a U.S. listing. Toss in Robinhood whenever it gets off its duff and gives us its own filing, and we’re being promised a good time.
Per Crunchbase data, Babylon has raised north of $600 million as a private company. Its funding, however, has not come from sources that we tend to discuss here at TechCrunch. Instead, the company raised some money from more traditional investors like Hoxton Ventures and Kinnevik, but the bulk of its capital was raised from the Saudi Arabian “Public Investment Fund,” or PIF. The PIF led a $550 million round into the British healthtech company back in August 2019.
PitchBook has the round cut into two parts, the larger, first portion of which valued the company at $1.9 billion on a post-money basis.
That figure brings us to the SPAC deal that Babylon is now pursuing. The company’s new equity value after its SPAC deal will land around $4.2 billion, with Babylon sitting on around $540 million in cash after the deal is completed. The company will sport a lower, $3.6 billion enterprise valuation after its merger with SPAC Alkuri.
The medical industry is sitting on a huge trove of data, but in many cases it can be a challenge to realize the value of it because that data is unstructured and in disparate places.
Today, a startup called Mendel, which has built an AI platform both to ingest and bring order to that body of information, is announcing $18 million in funding to continue its growth and to build out what it describes as a “clinical data marketplace” for people not just to organize, but also to share and exchange that data for research purposes. It’s also going to be using the funding to hire more talent — technical and support — for its two offices, in San Jose, CA and Cairo, Egypt.
The Series A round is being led by DCM, with OliveTree and MTVLP, and previous backers Launch Capital, SOSV, Bootstrap Labs and Chairman of UCSF Health Hub Mark Goldstein also participating.
The funding comes on the heels of what Mendel says is a surge of interest among research and pharmaceutical companies in sourcing better data to gain a better understanding of longer-term patient care and progress, in particular across wider groups of users, not just at a time when it has been more challenging to observe people and run trials, but in light of the understanding that using AI to leverage much bigger data sets can produce better insights.
This can be important, for example, in proactive identifying symptoms of particular ailments or the pathology of a disease, but also recurring and more typical responses to specific treatment courses.
We previously wrote about Mendel back in 2017 when the company had received a seed round of $2 million to better match cancer patients with the various clinical trials that are regularly being run: the idea was that certain trials address specific types of cancers and types of patients, and those who are willing to try newer approaches will be better or worse suited to each of these.
It turned out, however, that Mendel discovered a problem in the data that it would have needed to enable its matching algorithms to work, said Dr. Karim Galil, Mendel’s CEO and founder.
“As we were trying to build the trial business, we discovered a more basic problem that hadn’t been solved,” he said in an interview. “It was the reading and understanding medical records of a patient. If you can’t do that you can’t do trial matching.”
So the startup decided to become an R&D shop for at least three years to solve that problem before doing anything with trials, he continued.
Although there are today many AI companies that are parsing unstructured information in order to extract better insights, Mendel is what you might think of as part of the guard of tech companies that are building out specific AI knowledge bases for distinct verticals or areas of expertise. (Another example from another vertical is Eigen, working in the legal and finance industries, while Google’s DeepMind is another major AI player looking at ways of better harnessing data in the sphere of medicine.)
The issue of “reading” natural language is more nuanced than you might think in the world of medicine. Gali compared it to the phrase “I’m going to leave you” in English, which could just as easily mean someone is departing, say, a room, as someone is walking out of a relationship. The “true” answer — and as we humans know even truth can be elusive — can only start to be found in the context.
The same goes for doctors and their observation notes, Galil said. “There is a lot hidden between the lines, and problems can be specific to a person,” or to a situation.
That has proven to be a lucrative area to tackle.
Mendel uses a mix of computer vision and natural language processing built by teams with extensive experience in both clinical environments and in building AI algorithms and currently provides tools to automate clinical data abstraction, OCR, special tools to redact and remove personal identifiable information automatically to share records, search engines to search clinical data, and — yes — an engine to enable better matching of people to clinical trials. Customers include pharmaceutical and life science companies, real-world data and real-world evidence (RWD and RWE) providers and research groups.
And to underscore just how much there is still left to do in the world of medicine, along with this funding round, Mendel is announcing a partnership with eFax, an online faxing solution used by a huge number of healthcare providers.
Faxing is totally antiquated in some parts of the world now — I’m not even sure that people the age of my children (tweens) even know what a “fax” is — but they remain one of the most-used ways to transfer documents and information between people in the worlds of healthcare and medicine, with 90% of the industry using them today. The partnership with Mendel will mean that those eFaxes will now be “read” and digitized and ingested into wider platforms to tap that data in a more useful way.
“There is huge potential for the global healthcare industry to leverage AI,” said Mendel board member and partner at DCM, Kyle Lui, in a statement. “Mendel has created a unique and seamless solution for healthcare organizations to automatically make sense of their clinical data using AI. We look forward to continuing to work with the team on this next stage of growth.”
Tata Digital, a subsidiary of Indian conglomerate Tata Sons, said on Monday it has signed a deal to invest up to $75 million in fitness startup CureFit. As part of the deal, CureFit co-founder and chief executive Mukesh Bansal will join Tata Digital as President and continue in his role at the Bangalore-headquartered startup.
Monday’s investment is the salt-to-steel giant’s latest effort to expand its presence in the consumer tech space. Earlier this year, Tata Group acquired majority stakes in online grocery startup BigBasket, and is reportedly in talks to acquire online pharmacy 1mg, according to local media reports.
Prior to today’s announcement, CureFit had raised about $418 million and was last valued at $815 million, according to insight firm Tracxn.
“Joining Tata Digital marks an exciting new step for me and my team and is a recognition of the value we have created with CureFit for fitness enthusiasts in India. Being part of Tata Digital will enable us to nationally scale up our offerings for our customers,” said Bansal, who sold his previous venture Myntra to Flipkart, in a statement.
This is a developing story. More to follow…
Indonesian healthcare startup Prixa has raised $3 million led by MDI Ventures and the Trans-Pacific Technology Fund (TPTF), with participation from returning investors including Siloam Hospitals Group.
This brings Prixa’s total raised to $4.5 million since it launched in 2019. Co-founder and chief executive officer James Roring M.D., told TechCrunch in an email that the new funding will enable Prixa to scale its platform and customer base. Prixa uses a B2B model, partnering with healthcare payers like insurance providers and corporations. Through its B2B customers, it currently serves about 10 million patients.
Prixa currently works with four major insurers and has six additional insurers in its short-term pipeline. It also works with Indonesia’s largest third-party administrators, Roring said, allowing it to reach more policyholders.
Prixa’s platform includes a digital health assistant to answer patients’ questions, telemedicine consultations, pharmacy deliveries and on-demand lab diagnostics. Usage increased during the COVID-19 pandemic as more patients sought online consultations for primary care.
Other telehealth startups in Indonesia include Halodoc and Alodokter (which is also backed by MDI). Both connect patients directly with healthcare and insurance providers. Roring said Prixa differentiates by focusing on greater cost control for healthcare payers and positioning itself as a digital primary care platform.
“By symptomatically managing patients outside of tertiary care facilities and caring for chronic non-communicable diseases online, Prixa is able to effectively reduce the amount of outpatient claims and downstream inpatient cost incurred by healthcare payers,” Roring said. “Additionally, the combination of a growing and robust medical database, as well as proven clinical guidelines, contribute to cost efficiency and service optimization through the standardization of treatment by our healthcare providers.”
In press statement about the funding, Aditia Henri Narendra, MDI Ventures’ general manager of legal and corporate communication, said, “MDI co-led this financing because Prixa has demonstrated its ability to support insurance companies and hospitals in making medical services more accessible and affordable through its AI telemedicine platform.”
Gaslighting is a form of psychological abuse, but Elizabeth Ruzzo says she experienced it firsthand after telling a doctor that she suffered from suicidal ideation after taking birth control pills.
Hormonal health sits at the center of conversations around personalized medicine and women’s health: By 2025, women’s health could be a $50 billion industry, and by 2026, digital health more broadly is estimated to hit $221 billion.
Ruzzo’s doctor told her there was no connection between birth control and self-harm, but she decided to stop taking the pill to see if her mental health improved. When it did, Ruzzo grasped the disconnect between women’s unique hormonal makeup and blanket-statement practices from medicine today.
Her realization led her to found Adyn Health, a startup that proactively helps women make health decisions that complement their hormonal state and background. The company started with, of course, helping people pick more personalized birth control.
Ruzzo is part of a group of growing entrepreneurs who are betting that hormonal health is the key wedge into the digital health boom. Hormones are fluctuating, ever-evolving and diverse — but these founders say they’re also key to solving many health conditions that disproportionately impact women, from diabetes to infertility to mental health challenges.
Many believe it’s that complexity that underscores the opportunity. Hormonal health sits at the center of conversations around personalized medicine and women’s health: By 2025, women’s health could be a $50 billion industry, and by 2026, digital health more broadly is estimated to hit $221 billion.
Still, as funding for women’s health startups drops and stigma continues to impact where venture dollars go, it’s unclear whether the sector will remain in its infancy or hit a true inflection point.
Ruzzo views Adyn as a precision medicine startup. Its main product is an at-home test that tracks hormone levels, assesses genetic risk for specific side effects, and then gives recommendations for which birth control methods best suits the customer with the fewest side effects.
By Ruzzo’s estimates, 98% of sexually active women use birth control for 30 years of their life. That sort of lifetime value proposition made the company look like a sweet deal to founders, and Adyn raised a $2.5 million seed in April 2021 in a round co-led by Lux Capital and M13.
The moonshot, though, is using that as a way to become a trusted partner in a woman’s life, helping understand baseline hormone levels throughout those 30 years.
“My hope is that we can use precision medicine approaches, including looking at genetic markers to identify reliable diagnostic criteria, that can remove that uncertainty and pain and diagnostic odyssey that people have to go through,” Ruzzo said.
If Adyn becomes a trusted partner with teenage women, it could reach a point where it can detect changes in hormone levels over time.
“The hormone reference ranges that are used [in labs] are too broad to be personalized, let alone prescriptive,” she said. “And so what we’re hoping to do is correct for things that we know affect hormone levels like age, weight, ethnicity and compare you to your own expectations.”
If the first wave of digital health was a company like Ro, which answers consumers when they have a condition such as erectile dysfunction or hair loss, the second wave will look more like Adyn, which helps consumers navigate their health before getting diagnosed with a condition or experiencing issues.
The industry standard is still to wait for consumers to realize they have a condition, and then go to the doctor to manage their symptoms or look for a cure. A new startup that recently graduated from Y Combinator is finding its way into hormonal health through that angle.
Veera Health is a startup that wants to help women in India manage polycystic ovary syndrome, or PCOS. The hormonal condition can cause irregular periods, infertility or gestational diabetes in women, as well as acne, weight gain and excessive hair growth. Plus, PCOS is far from rare, impacting one in 10 women.
This may seem like a great time to launch a SaaS startup, but the landscape is crowded with well-designed applications that promise “blazingly fast and delightfully simple” experiences, according to seed-stage investor John Chen of Fika Ventures.
Most SaaS startups will fail, but not because of a sour marketing campaign or server downtime. The majority of these companies will fall victim to what Chen calls “the myth of frictionless onboarding.”
Despite the hype about ease of use, enterprise companies always ask customers to abandon familiar tools so they can learn something new.
“Just like with a new fitness program, participants feel good after completing the workout, but it takes a lot of activation energy to start and hard work to get there,” Chen notes.
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Instead of putting the onus on customers to roll up their sleeves, he suggests that SaaS startups learn from cryptocurrency culture and find ways to “incentivize users to do the necessary work to have the right experience.”
But how do you encourage users to put in the time and effort required to produce an optimal customer experience?
“In a world where there is a surplus of alternatives for every job to be done, the scarce resource is not content, tooling, or hacks and tricks,” says Chen. “It’s attention.”
We’re off on Monday, May 31 in observance of Memorial Day; I hope you have a relaxing weekend!
Senior Editor, TechCrunch
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As startups and venture capital grow in tandem, fundraising has gone from a formal affair on Sand Hill Road to a process that can happen anywhere from Twitter to Zoom.
While fundraising may no longer require a trip to California, it might depend on whether you got an invite to a private audio app. And while you may not need to be an insider, second-time founders — largely male and white — still have a competitive advantage.
The growing complexity of fundraising has the opportunity to make tech either inclusive or exclusive.
VC is the flashy gold medal, but the rapid growth of emerging fund managers means that a first check can be piecemealed together from a variety of different sources. The options for financing are seemingly endless: syndicates, public crowdfunding, VC firms, accelerators, debt financing, rolling funds, and, for the profitable few, bootstrapping.
Telehealth startup Doximity filed to go public earlier today. Notably, the company has not fundraised since 2014, a year in which it attracted just under $82 million at a valuation of $355 million, per PitchBook data.
How has it managed to not raise money for so long? By generating lots of cash and profit over the years. Healthtech communications, it turns out, can be a lucrative endeavor.
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The spin-out of video platform Vimeo from IAC completed this week, and the smaller company is now trading as an independent entity under the ticker ‘VMEO’.
If you missed the news that the internet conglomerate was spinning out the video service, don’t feel bad; it slipped past many radars. But with the company now trading, our access to its historical results, and our minds still enthralled by YouTube’s recent financial performance for Alphabet, it’s worth taking a moment to digest the company’s health.
The Flywire IPO is neat from a financial perspective and notable in that it’s a Boston exit as opposed to yet another New York or San Francisco-based flotation. It’s nice to see some other cities put points on the board.
But more than that, this IPO is a useful measuring stick for keeping tabs on the IPO market as a whole. This year and the last are shaping up to be key exit periods for startups and unicorns of all shapes and sizes; many a venture capital fund return rests on these public debuts.
Image Credits: Bryce Durbin/TechCrunch
I do recruitment for tech startups. With a surge of VC investing, many startups are urgently hiring.
Which visas offer the quickest options for international talent? Are there any unique strategies that you would recommend we explore?
— Maverick in Milpitas
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Cities like Miami, Pittsburgh and Austin have been drawing talent and wealth from Silicon Valley for years, but the COVID-19 pandemic accelerated the trend.
In recent months, many investors and entrepreneurs have noisily departed for Miami, citing the region’s favorable business climate and quality of life.
It’s always good to consider one’s options, but before booking a moving van for the Sunshine State — or any emerging tech hub, for that matter — here are some basic questions entrepreneurs should ask themselves.
Image Credits: Sequoia Capital / Wolfe + Von / TechCrunch
In just a few short years, Vise has gone from launching on the Disrupt Battlefield stage to a unicorn. Co-founders Samir Vasavada and Runik Mehrotra met Sequoia’s Shaun Maguire at an after-party at the event, and Maguire ended up leading a seed and Series A round while Sequoia led the Series B.
Last week, Vise raised its Series C of $65 million and was officially valued at $1 billion post-money.
We spoke to the pair about the early fundraising process for Vise, what Vasavada has learned about delivering a good fundraising pitch, and what stood out about the pitch and the product for Maguire.
Another day, another unicorn public offering.
On Thursday, it was Acorns, a consumer fintech service that blends saving and investing into a freemium product.
Acorns fits inside the larger savings-and-investing boom seen over the last four or five quarters as consumers buffeted by the economic changes brought on by COVID-19 turned to stashing cash and boosting their equities investing cadence.
By now this is old news, but we haven’t had a clear picture of the economics of consumer fintech startups accelerated by the pandemic. Now that Acorns has decided to list via a SPAC — more on that in a moment — we do.
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The world of hybrid work is here, and the usual 10-minute intro call, swag bag and first-day team lunch are just not enough to make your new employee feel welcome.
While many companies have found a way to interview and select candidates in a fully remote environment, few have spent time and resources on aligning the “pre-boarding” and onboarding process for the new hybrid world of work. Many employers still rely on old ways of welcoming new hires, despite our totally changed work environment.
It’s important to capitalize on candidates’ enthusiasm and eagerness from the moment the offer is signed instead of when they log in on Day One, because first impressions can make or break a candidate’s chances of staying at a company.
There was a time when this column was more than a never-ending run of IPO coverage. Then the unicorn liquidity cycle kicked off and it’s been a long run of public offerings ever since. This morning is no exception.
Doximity filed to go public earlier today. You likely haven’t heard of the company because it exists in the modestly obscure world of telehealth. But it’s a venture-backed startup all the same that raised more than $80 million from investors like Emergence, InterWest Partners, Morgenthaler Ventures and Threshold, according to Crunchbase data.
Notably, Doximity has not fundraised since 2014, a year in which it attracted just under $82 million at a valuation of $355 million, per PitchBook data. How has it managed to not raise for so long? By generating lots of cash and profit over the years. Healthtech communications, it turns out, can be a lucrative endeavor.
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Doximity is a social network that allows doctors to speak to each other while complying with HIPAA, a federal law that promotes medical privacy. The network, originally defined as a LinkedIn for medical professionals, gives doctors a Rolodex for specialists, a newsfeed for healthcare updates, a communication tool to talk to patients, and a job search tool.
In 2017, Doximity claimed that it reached 70% of all U.S. doctors, more than 800,000 licensed professionals.
This is CEO Jeff Tangney’s second time bringing a healthtech company public after his previous medical software startup, Epocrates, debuted in 2011.
Let’s chat briefly about the larger healthtech exit market and then dig into Doximity’s IPO filing and get our heads around how the company managed to avoid private-market dilution for seven years — and what the company may be worth.
The global digital health market is estimated to hit $221 billion by 2026, underscoring how large an opportunity the sector may present to venture capitalists. But investors aren’t merely just paying attention to estimates; they are seeing a number of exits in digital health (read: liquidity) that are warming up their checkbooks.
CB Insights estimates that there were 79 healthcare IPOs and M&A transactions in Q1 2021 alone, a 60% increase from the quarter prior. Another report says that there were 145 acquisitions of digital health companies in 2020, up from a solid 113 in 2019.
While still growing, it’s fair to say that those figures describe a healthy exit environment.
The list of deals in the market is rapid-fire. Earlier this year, Everlywell, founded in 2015, acquired two healthcare companies to expand its digital health service and distribution. Last week, Modern Fertility was bought by Ro for north of $225 million in a majority-equity deal. Before you start complaining that it’s not an IPO, consider this: A less than four-year-old company just got bought for a quarter of a billion dollars by another company that is less than four years old.
The digital health space continues cooking on gas: Berlin-based Ada Health has closed a $90M Series B round of funding led by Leaps by Bayer, the impact investment arm of the German multinational pharma giant, Bayer AG. Other investors in the round include Samsung Catalyst Fund, Vitruvian Partners, Inteligo Bank, F4 and Mutschler Ventures.
The startup last raised around four years’ ago, reporting a $47M Series A round in 2017. But don’t be fooled by the low lettering of these rounds: Ada Health has been working on its symptom assessment tech for around a decade at this point — relying, in the first several years of its mission, on private funding from high net worth individuals in Germany and elsewhere in Europe.
Initially it was also focused on building a decision support tool for doctors before pivoting to directly addressing patients via an AI-driven symptom assessment app.
It’s not alone in offering this type of tool. Others in the space include Babylon, Buoy, K Health, Mediktor, Symptomate, WebMD and Your.MD — but Ada claims its app is the most used and highest rated by users. It can also point to a peer reviewed study it led, which was published in the BMJ, and compared the condition coverage, accuracy and safety of eight competitors. The study found its app led the pack on all fronts.
One reason for that edge is that Ada Health’s medical knowledge base covers around 30,000 ICD-10 codes (aka the alphanumeric codes used by doctors to represent different diagnoses) at this point — which co-founder and CEO, Daniel Nathrath, tells us is “by far the largest coverage of any of the systems in this space”.
The Ada Health app, which launched in late 2016 — and remains free to use — has been downloaded by more than 11 million people across 150 countries so far. Users have completed some 23M assessments using the tool which he likens to having “24/7 access to your trusted family doctor”.
Currently, the app has support for 10 languages. But the goal with the funding is to push for truly massive scale.
“The idea is to help as many people as possible get better access to healthcare around the world,” Nathrath tells TechCrunch. “Our ambition is, in a few years, that a billion people instead of 11M people will be using out technology. In order to get there we think that working with the right investors can help us accelerate that growth path and give more people the benefit of our technology faster.”
“With 11M app downloads I believe we are the most used AI symptom assessment technology that I know of in the world,” he goes on. “We are also the most rated and reviewed app in the medical category of the App Store and Google Play Store ever — after, what, just four years. With about 300,000 ratings and reviews, most of them five-star. So… we have gained some users but we think it’s just the beginning.
“Digital health — with all the things you see going on — is at an inflection point where it’s being realized not only by the users who have already been using our technology but also by health systems, governments, and payers, insurers, and life sciences companies — I think everyone has realized digital health is here to stay.”
As well as putting its symptom assessment app directly in the hands of patients, Ada Health offers a suite of enterprise solutions where partners pay it to be able to embed and deeply integrate its triage technology into their websites and digital services. That means they can use it to offer an entry point for their users — to help direct them to the correct service and provide administrative support by arming clinicians with health information provided by patient via the Ada interface (and the AI’s own assessment) ahead of the appointment.
One publicly disclosed customer for Ada’s enterprise offering is Sutter Health, in the Bay Area.
“They have integrated Ada into their own homepage and into their app so people can use it as a digital front door to the entire service of Sutter,” says Nathrath, explaining that the difference vs the version of the app that patients can download is “people don’t just get generic advice”. “It’s fully integrated. So if it says — for instance — you need to go to the emergency room… then you can go straight into appointment booking.
“And not only that; when you book the appointment the outcome of the Ada pre-assessment can then be shared with the health professional who will then look at you so the doctor doesn’t start from a blank sheet of paper but is already pre-briefed and gets decision support in terms of ‘this is constellation of symptoms the patient is reporting’ and ‘based on that these could be the most likely diagnosis and these should be the tests, examinations or investigations I should consider next to get to the confirmed diagnosis’.”
The added advantage for Ada’s enterprise partners is that patient data arrives with the doctor that sees them already structured so — after a few confirmations — they can easily import it into their documentation, saying precious minutes per patient, per Nathrath. “[If] you save a few minutes with each patient that means you have more time for the patients who really need you and not the patients who maybe has a cold and shows up in the emergency room, which unfortunately is a reality,” he adds.
With this enterprise strand of its business Ada is continuing to provide support for doctors. Nathrath suggests its patient-facing app is also being used for some informal decision support for doctors too.
More and more doctors are using the app “together with their patients”, he tells us, or else recommending it to their patients — asking them “so what did Ada say?”.
The role of AI in healthcare will be a core one, Nathrath predicts — given that demand for healthcare professionals is always going to outstrip supply.
He argues that’s true even with rising use of telehealth platforms which can certainly make more efficient use of doctors’ time.
Ada did, at one point, offer a telehealth service itself — before deciding to fully focus its efforts on AI — so it’s approach now is to partner and integrate with other healthcare and health data providers throughout the care ecosystem.
“We think there’s a place for telehealth, obviously. It adds convenience. During the pandemic I guess it had a special role where for many it was almost the only way to interact with a doctor,” he says. “So we do see a place for telehealth but we also see an issue with telehealth in that it doesn’t address the structural issue in healthcare — that simply there aren’t enough doctors to serve the entire population of the world.”
“We’re building Ada as a multi-sided platform,” he adds. “We’ll be computing different sources of input data — which is sensor data, wearables data, lab data, genetic testing data — that’s on the input side — and then on the more downstream, on the next step after Ada, we can partner with any telehealth company in the world. And we’re seeing enormous interest from literally all corners of the world where telehealth companies approach us. And insurance companies and governments — where they say yes there is a use-case for telehealth but we basically need something before that, that filters people to the right next step.”
Whatever that right next step is in a patient’s care journey, “Ada is like the gatekeeper at the beginning of the journey that then sends you on your way,” is how Nathrath puts it.
The overarching vision is that Ada becomes not just an app in your pocket but an omnipresent “personal health companion” — or what it describes as “a personal operating system for health” — which is powerful enough to deliver preventative healthcare by being able to aggregate all sorts of data and spot health issues sooner so as to enable earlier and less costly interventions.
“What we’re building is really much more than a symptom assessment technology,” he tells TechCrunch. “Where you would also take into account lab results which can now be done much more direct to consumer than was previously possible, sensors and wearables data — and you probably say that Samsung is one of our investors but we’re obviously talking to all the large players in the space about this; how we can integrate that data best — and all the way to genetic testing and even the full genome sequence.
“When you take all these different sources of health information and compute them against each other on a continuous basis you’ll have something like an early warning system for your health — which, again, from a population health and system level perspective should be desirable for anyone who’s in charge of providing healthcare or paying for healthcare because you can catch the problem when it’s still a £100 problem and not yet a £100,000 a year problem.”
Given that ambition it’s interesting that big pharma is investing in Ada. (And its PR notes that it’s also in talks with Bayer on a potential strategic partnership.) But Nathrath suggests that the industry is well aware of the shifts being driven by digital health — and keen to avoid it’s own ‘Kodak moment’, i.e. by not adapting to the coming changes in a timely enough manner.
If AI-powered health interventions end up being so successful that they can shrink drug bills through earlier intervention and more preventative care then it makes good business sense for big pharma to be plugged into the cutting edge of digital health.
At the same time this type of tech might end up driving demand for medicines — exactly because of its scalability and because it can present a higher dimension view of more people’s health — meaning there’s more opportunity for increased prescription. So there’s not really a downside for pharma to get involved here.
“We’re really excited about the possibilities we can find by working together [with pharmaceutical companies] to really deliver a better healthcare experience to patients,” says Nathrath. “If you look at Bayer they have a consumer health business, they also have a pharmaceutical business and if you look at the cases within Ada if you look at the top ten most common ones it’s very comparable to what a GP would see all the time and a lot of those basically can end up in the recommendation towards healthcare where oftentimes an over the counter drug will be enough to address the issue. One area where Bayer has a lot of offerings, of course. But then their spectrum goes all the way towards rare diseases — where we’re also particularly strong. Where they have some drugs that help patients with very rare conditions.”
There are also potentially major research riches to be derived from the health data generated via Ada’s app which could also be interesting to pharma companies doing drug discovery.
Although Nathrath emphasizes that app users’ data is never used for research purpose without explicit consent from the individual (as is required under Europe’s General Data Protection Act).
But he also notes that Ada is able to do some interesting studies based on aggregated user data, too — giving an example of how it looked at kids mental health during COVID-19 lockdowns, comparing areas where schools had been shut vs those where they had remained open. “You could really compare what happened in different countries,” he says, noting that rates of depression in kids in Germany where schools and pre-schools were closed went up by over 100%, whereas in Switzerland where schools remained opened throughout there was no rise and even a slight improvement in children’s mental health.
In another example, involving aggregated data from usage of the app in US, he says it was able to show that it could have spotted a measles epidemic via the cases in the app slightly sooner than the CDC’s official announcement of an epidemic.
“If you think about the potential of that, in terms of spotting outbreaks earlier, that can be quite significant,” he suggests.
“We think there’s really a long list of ways we can work together [with researchers, policymakers and pharma companies] for the benefit of patients,” he adds. “The mission of all the people I spoke to at Bayer was really similar to ours — which is to help people, basically… That’s why we’re really happy to work with them.”
Commenting on the funding in a statement, Dr. Jürgen Eckhardt, head of Leaps by Bayer, added: “Investing in breakthrough technologies that drive digital change in healthcare is one of the strategic imperatives for Leaps by Bayer and for the entire field of healthcare. Ada’s truly transformative technology, combining powerful artificial intelligence with an emphasis on medical rigor and high levels of clinical accuracy will lead the way in helping more patients and consumers in achieving better health outcomes sooner by intervening earlier in their healthcare journey.”
Security researchers say at-home exercise giant Peloton and its closest rival Echelon were not stripping user-uploaded profile photos of their metadata, in some cases exposing users’ real-world location data.
Almost every file, photo or document contains metadata, which is data about the file itself, such as how big it is, when it was created, and by whom. Photos and video will often also include the location from where they were taken. That location data helps online services tag your photos or videos that you were at this restaurant or that other landmark.
But those online services — especially social platforms, where you see people’s profile photos — are supposed to remove location data from the file’s metadata so other users can’t snoop on where you’ve been, since location data can reveal where you live, work, where you go, and who you see.
Jan Masters, a security researcher at Pen Test Partners, found the metadata exposure as part of a wider look at Peloton’s leaky API. TechCrunch verified the bug by uploading a profile photo with GPS coordinates of our New York office, and checking the metadata of the file while it was on the server.
The bugs were privately reported to both Peloton and Echelon.
Peloton fixed its API issues earlier this month but said it needed more time to fix the metadata bug and to strip existing profile photos of any location data. A Peloton spokesperson confirmed the bugs were fixed last week. Echelon fixed its version of the bug earlier this month. But TechCrunch held this report until we had confirmation that both companies had fixed the bug and that metadata had been stripped from old profile photos.
It’s not known how long the bug existed or if anyone maliciously exploited it to scrape users’ personal information. Any copies, whether cached or scraped, could represent a significant privacy risk to users whose location identifies their home address, workplace, or other private location.
Parler infamously didn’t scrub metadata from user-uploaded photos, which exposed the locations of millions of users when archivists exploited weaknesses on the platform’s API to download its entire contents. Others have been slow to adopt metadata stripping, like Slack, even if it got there in the end.
Hello and welcome back to Equity, TechCrunch’s venture capital-focused podcast, where we unpack the numbers behind the headlines.
For this week’s deep dive, Alex and Natasha dug into Danny’s latest mega-project: A long, fascinating and deeply reported series into the world of disaster tech. It’s all about the market, startups and their backers, so it was perfect fare for our Wednesday episode, in which we dive deep into a single topic.
We were super curious why Danny had picked disaster tech to niche into, as we hadn’t heard that much about it, frankly. But past the fact that it’s a world where sales cycles can last as long as House Congressional tenures, there was quite a lot to get into:
The series was fun to mine through, and expect Danny’s byline to be all over the topic in the coming weeks. Talk soon, unless — actually especially, if — all of hell breaks loose!
Facebook this week will begin to publicly roll out the option to hide Likes on posts across both Facebook and Instagram, following earlier tests beginning in 2019. The project, which puts the decision about Likes in the hands of the company’s global user base, had been in development for years, but was deprioritized due to the COVID-19 pandemic and the response work required on Facebook’s part, the company says.
Originally, the idea to hide Like counts on Facebook’s social networks was focused on depressurizing the experience for users. Often, users faced anxiety and embarrassment around their posts if they didn’t receive enough Likes to be considered “popular.” This problem was particularly difficult for younger users who highly value what peers think of them — so much so that they would take down posts that didn’t receive enough Likes.
Like-chasing on Instagram, especially, also helped create an environment where people posted to gain clout and notoriety, which can be a less authentic experience. On Facebook, gaining Likes or other forms of engagement could also be associated with posting polarizing content that required a reaction.
As a result of this pressure to perform, some users grew hungry for a “Like-free” safer space, where they could engage with friends or the wider public without trying to earn these popularity points. That, in turn, gave rise to a new crop of social networking and photo-sharing apps such as Minutiae, Vero, Dayflash, Oggl and, now, newcomers like Dispo and newly viral Poparazzi.
Though Facebook and Instagram could have chosen to remove Likes entirely and take its social networks in a new direction, the company soon found that the metric was too deeply integrated into the product experience to be fully removed. One key issue was how the influencer community today trades on Likes as a form of currency that allows them to exchange their online popularity for brand deals and job opportunities. Removing Likes, then, is not necessarily an option for these users.
Instagram realized that if it made a decision for its users, it would anger one side or the other — even if the move in either direction didn’t really impact other core metrics, like app usage.
Image Credits: Instagram
“How many likes [users] got, or other people got — it turned out that it didn’t actually change nearly as much about the experience, in terms of how people felt or how much they use experience, as we thought it would. But it did end up being pretty polarizing,” admitted Instagram head, Adam Mosseri. “Some people really liked it and some people really didn’t.”
“For those who liked it, it was mostly what we had hoped — which is that it depressurized the experience. And, for those who didn’t, they used Likes to get a sense for what was trending or was relevant on Instagram and on Facebook. And they were just super annoyed that we took it away,” he added. This latter group sometimes included smaller creators still working on establishing a presence across social media, though larger influencers were sometimes in favor of Like removals. (Mosseri name-checked Katy Perry as being pro Like removals, in fact.)
Ultimately, the company decided to split the difference. Instead of making a hard choice about the future of its online communities, it’s rolling out the “no Likes” option as a user-controlled setting on both platforms.
On Instagram, both content consumers and content producers can turn on or off Like and View counts on posts — which means you can choose to not see these metrics when scrolling your own Feed and you can choose whether to allow Likes to be viewed by others when you’re posting. These are configured as two different settings, which provides for more flexibility and control.
Image Credits: Instagram
On Facebook, meanwhile, users access the new setting from the “Settings & Privacy” area under News Feed Settings (or News Feed Preferences on desktop). From here, you’ll find an option to “Hide number of reactions” to turn this setting off for both your own posts and for posts from others in News Feed, groups and Pages.
The feature will be made available to both public and private profiles, Facebook tells us, and will include posts you’ve published previously.
Image Credits: Facebook
Instagram last month restarted its tests on this feature in order to work out any final bugs before making the new settings live for global users, and said a Facebook test would come soon. But it’s now forging ahead with making the feature available publicly. When asked why such a short test, Instagram told TechCrunch it had been testing various iterations on this experience since 2019, so it felt it had enough data to proceed with a global launch.
Mosseri also pushed back at the idea that a decision on Likes would have majorly impacted the network. While removal of Likes on Instagram had some impact on user behavior, he said, it was not enough to be concerning. In some groups, users posted more — signaling that they felt less pressure to perform, perhaps. But others engaged less, Mosseri said.
Image Credits: Facebook
“Often people say, ‘oh, this has a bunch of Likes. I’m gonna go check it out,’ ” the exec explained. “Then they read the comments, or go deeper, or swipe to the carousel. There’s been some small effects — some positive, some negative — but they’ve all been small,” he noted. Instagram also believes users may toggle on and off the feature at various times, based on how they’re feeling.
In addition, Mosseri pointed out, “there’s no rigorous research that suggests Likes are bad for people’s well-being” — a statement that pushes back over the growing concerns that a gamified social media space is bad for users’ mental health. Instead, he argued that Instagram is still a small part of people’s day, so how Likes function doesn’t affect people’s overall well-being.
“As big as we are, we have to be careful not to overestimate our influence,” Mosseri said.
He also dismissed some of the current research pointing to negative impacts of social media use as being overly reliant on methodologies that ask users to self-report their use, rather than measure it directly.
In other words, this is not a company that feels motivated to remove Likes entirely due to the negative mental health outcomes attributed to its popularity metrics.
It’s worth mentioning that another factor that could have come into play here is Instagram’s plan to make a version of its app available to children under the age of 13, as competitor TikTok did following its FTC settlement. In that case, hiding Likes by default — or perhaps adding a parental control option — would necessitate such a setting. Instagram tells TechCrunch that, while it’s too soon to know what it would do with a kids app, it will “definitely explore” a no Likes by default option.
Facebook and Instagram both told TechCrunch the feature will roll out starting on Wednesday but will reach global users over time. On Instagram, that may take a matter of days.
Facebook, meanwhile, says a small percentage of users will have the feature Wednesday — notified through an alert on News Feed — but it will reach Facebook’s global audience “over the next few weeks.”