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The cocktail party problem: Why voice tech isn’t truly useful yet

By Ram Iyer
Ken Sutton Contributor
Ken Sutton is CEO and co-founder of Yobe, a software company that uses edge-based AI to unlock the potential of voice technologies for modern brands.

On average, men and women speak roughly 15,000 words per day. We call our friends and family, log into Zoom for meetings with our colleagues, discuss our days with our loved ones, or if you’re like me, you argue with the ref about a bad call they made in the playoffs.

Hospitality, travel, IoT and the auto industry are all on the cusp of leveling-up voice assistant adoption and the monetization of voice. The global voice and speech recognition market is expected to grow at a CAGR of 17.2% from 2019 to reach $26.8 billion by 2025, according to Meticulous Research. Companies like Amazon and Apple will accelerate this growth as they leverage ambient computing capabilities, which will continue to push voice interfaces forward as a primary interface.

As voice technologies become ubiquitous, companies are turning their focus to the value of the data latent in these new channels. Microsoft’s recent acquisition of Nuance is not just about achieving better NLP or voice assistant technology, it’s also about the trove of healthcare data that the conversational AI has collected.

Our voice technologies have not been engineered to confront the messiness of the real world or the cacophony of our actual lives.

Google has monetized every click of your mouse, and the same thing is now happening with voice. Advertisers have found that speak-through conversion rates are higher than click-through conversation rates. Brands need to begin developing voice strategies to reach customers — or risk being left behind.

Voice tech adoption was already on the rise, but with most of the world under lockdown protocol during the COVID-19 pandemic, adoption is set to skyrocket. Nearly 40% of internet users in the U.S. use smart speakers at least monthly in 2020, according to Insider Intelligence.

Yet, there are several fundamental technology barriers keeping us from reaching the full potential of the technology.

The steep climb to commercializing voice

By the end of 2020, worldwide shipments of wearable devices rose 27.2% to 153.5 million from a year earlier, but despite all the progress made in voice technologies and their integration in a plethora of end-user devices, they are still largely limited to simple tasks. That is finally starting to change as consumers demand more from these interactions, and voice becomes a more essential interface.

In 2018, in-car shoppers spent $230 billion to order food, coffee, groceries or items to pick up at a store. The auto industry is one of the earliest adopters of voice AI, but in order to really capture voice technology’s true potential, it needs to become a more seamless, truly hands-free experience. Ambient car noise still muddies the signal enough that it keeps users tethered to using their phones.

Startups should look to state-of-the-art tech to tackle diseases affecting women

By Annie Siebert
Shahar Keinan Contributor
Shahar Keinan, co-founder and CEO of Polaris Quantum Biotech has over 20 years of extensive experience in computational and theoretical chemistry.
Pek Lum Contributor
Pek Lum, co-founder and CEO at Auransa, has more than 20 years of genomics and drug discovery experience and is the chief architect behind Auransa’s technology.

Startups devoted to reproductive and women’s health are on the rise. However, most of them deal with women’s fertility: birth control, ovulation and the inability to conceive. The broader field of women’s health remains neglected.

Historically, most of our understanding of ailments comes from the perspective of men and is overwhelmingly based on studies using male patients. Until the early 1990s, women of childbearing age were kept out of drug trial studies, and the resulting bias has been an ongoing issue in healthcare. Other issues include underrepresentation of women in health studies, trivialization of women’s physical complaints (which is relevant to the misdiagnosis of endometriosis, among other conditions), and gender bias in the funding of research, especially in research grants.

For example, several studies have shown that when we look at National Institutes of Health funding, a disproportionate share of its resources goes to diseases that primarily affect men — at the expense of those that primarily affect women. In 2019, studies of NIH funding based on disease burden (as estimated by the number of years lost due to an illness) showed that male-favored diseases were funded at twice the rate of female-favored diseases.

Let’s take endometriosis as an example. Endometriosis is a disease where endometrial-like tissue (‘‘lesions’’) can be found outside the uterus. Endometriosis is a condition that only occurs in individuals with uteruses and has been less funded and less studied than many other conditions. It can cause chronic pain, fatigue, painful intercourse and infertility. Although the disease may affect one out of 10 women, diagnosis is still very slow, and the disease is confirmed only by surgery.

There is no non-invasive test available. In many cases, a woman is diagnosed only due to her infertility, and the diagnosis can take up to 10 years. Even after diagnosis, the understanding of disease biology and progression is poor, as well as the understanding of the relationships to other lesion diseases, such as adenomyosis. Current treatments include surgical removal of lesions and drugs that suppress ovarian hormone (mainly estrogen) production.

However, there are changes in the works. The NIH created the women’s health research category in 1994 for annual budgeting purposes and, in 2019, it was updated to include research that is relevant to women only. In acknowledging the widespread male bias in both human and animal studies, the NIH mandated in 2016 that grant applicants would be required to recruit male and female participants in their protocols. These changes are slow, and if we look at endometriosis, it received just $7 million in NIH funding in the fiscal year 2018, putting it near the very bottom of NIH’s 285 disease/research areas.

It is interesting to note that critical changes are coming from other sources, and not so much from the funding agencies or the pharmaceutical industry. The push is coming from patients and physicians themselves that meet the diseases regularly. We see pharmaceutical companies (such as Eli Lilly and AbbVie) in the women’s healthcare space following the lead of their patients and slowly expanding their R&D base and doubling efforts to expand beyond reproductive health into other key women’s health areas.

New technological innovations targeting endometriosis are being funded via private sources. In 2020, women’s health finally emerged as one of the most promising areas of investment. These include (not an exhaustive list by any means) diagnostics companies such as NextGen Jane, which raised a $9 million Series A in April 2021 for its “smart tampon,” and DotLab, a non-invasive endometriosis testing startup, which raised $10 million from investors last July. Other notable advances include the research-study app Phendo that tracks endometriosis, and Gynica, a company focused on cannabis-based treatments for gynecological issues.

The complexity of endometriosis is such that any single biotech startup may find it challenging to go it alone. One approach to tackle this is through collaborations. Two companies, Polaris Quantum Biotech and Auransa, have teamed up to tackle the endometriosis challenge and other women’s specific diseases.

Using data, algorithms and quantum computing, this collaboration between two female-led AI companies integrates the understanding of disease biology with chemistry. Moreover, they are not stopping at in silico; rather, this collaboration aims to bring therapeutics to patients.

New partnerships can majorly impact how fast a field like women’s health can advance. Without such concerted efforts, women-centric diseases such as endometriosis, triple-negative breast cancer and ovarian cancer, to name a few, may remain neglected and result in much-needed therapeutics not moving into clinics promptly.

Using state-of-the-art technologies on complex women’s diseases will allow the field to advance much faster and can put drug candidates into clinics in a few short years, especially with the help of patient advocacy groups, research organizations, physicians and out-of-the-box funding approaches such as crowdfunding from the patients themselves.

We believe that going after the women’s health market is a win-win for the patients as well as from the business perspective, as the global market for endometriosis drugs alone is expected to reach $2.2 billion in the next six years.

Google confirms it’s pulling the plug on Streams, its UK clinician support app

By Natasha Lomas

Google is infamous for spinning up products and killing them off, often in very short order. It’s an annoying enough habit when it’s stuff like messaging apps and games. But the tech giant’s ambitions stretch into many domains that touch human lives these days. Including, most directly, healthcare. And — it turns out — so does Google’s tendency to kill off products that its PR has previously touted as ‘life saving’.

To wit: Following a recent reconfiguration of Google’s health efforts — reported earlier by Business Insider — the tech giant confirmed to TechCrunch that it is decommissioning its clinician support app, Streams.

The app, which Google Health PR bills as a “mobile medical device”, was developed back in 2015 by DeepMind, an AI division of Google — and has been used by the UK’s National Health Service in the years since, with a number of Trusts inking deals with DeepMind Health to roll out Streams to their clinicians.

At the time of writing, one NHS Trust — London’s Royal Free — is still using the app in its hospitals.

But, presumably, not for too much longer since Google is in the process of taking Streams out back to be shot and tossed into its deadpool — alongside the likes of its ill-fated social network, Google+, and Internet ballon company Loon, to name just two of a frankly endless list of now defunct Alphabet/Google products.

Other NHS Trusts we contacted which had previously rolled out Streams told us they have already stopped using the app.

University College London NHS Trust confirmed to TechCrunch that it severed ties with Google Health earlier this year.

“Our agreement with Google Health (initially DeepMind) came to an end in March 2021 as originally planned. Google Health deleted all the data it held at the end of the [Streams] project,” a UCL NHS Trust spokesperson told TechCrunch.

Imperial College Healthcare NHS Trust also told us it stopped using Streams this summer (in July) — and said patient data is in the process of being deleted.

“Following the decommissioning of Streams at the Trust earlier this summer, data that has been processed by Google Health to provide the service to the Trust will be deleted and the agreement has been terminated,” a spokesperson said.

“As per the data sharing agreement, any patient data that has been processed by Google Health to provide the service will be deleted. The deletion process is started once the agreement has been terminated,” they added, saying the contractual timeframe for Google deleting patient data is six months.

Another Trust, Taunton & Somerset, also confirmed its involvement with Streams had already ended. 

The Streams deals DeepMind inked with NHS Trusts were for five years so these contracts were likely approaching the end of their terms, anyway.

Contract extensions would have had to be agreed by both parties. And Google’s decision to decommission Streams may be factoring in a lack of enthusiasm from involved Trusts to continue using the software — although if that’s the case it may, in turn, be a reflection of Trusts’ perceptions of Google’s weak commitment to the project.

Neither side is saying much publicly.

But as far as we’re aware the Royal Free is the only NHS Trust still using the clinician support app as Google prepares to cut off Stream’s life support.

No more Streams?

The Streams story has plenty of wrinkles, to put it politely.

For one thing, despite being developed by Google’s AI division — and despite DeepMind founder Mustafa Suleyman saying the goal for the project was to find ways to integrate AI into Streams so the app could generate predictive healthcare alerts — it doesn’t involve any artificial intelligence.

An algorithm in Streams alerts doctors to the risk of a patient developing acute kidney injury but relies on an existing AKI (acute kidney injury) algorithm developed by the NHS. So Streams essentially digitized and mobilized existing practice.

As a result, it always looked odd that an AI division of an adtech giant would be so interested in building, provisioning and supporting clinician support software over the long term. But then — as it panned out — neither DeepMind nor Google were in it for the long haul at the patient’s bedside.

DeepMind and the NHS Trust it worked with to develop Streams (the aforementioned Royal Free) started out with wider ambitions for their partnership — as detailed in an early 2016 memo we reported on, which set out a five year plan to bring AI to healthcare. Plus, as we noted above, Suleyman keep up the push for years — writing later in 2019 that: “Streams doesn’t use artificial intelligence at the moment, but the team now intends to find ways to safely integrate predictive AI models into Streams in order to provide clinicians with intelligent insights into patient deterioration.”

A key misstep for the project emerged in 2017 — through press reporting of a data scandal, as details of the full scope of the Royal Free-DeepMind data-sharing partnership were published by New Scientist (which used a freedom of information request to obtain contracts the pair had not made public).

The UK’s data protection watchdog went on to find that the Royal Free had not had a valid legal basis when it passed information on millions of patients’ to DeepMind during the development phase of Streams.

Which perhaps explains DeepMind’s eventually cooling ardour for a project it had initially thought — with the help of a willing NHS partner — would provide it with free and easy access to a rich supply of patient data for it to train up healthcare AIs which it would then be, seemingly, perfectly positioned to sell back into the self same service in future years. Price tbc.

No one involved in that thought had properly studied the detail of UK healthcare data regulation, clearly.

Or — most importantly — bothered to considered fundamental patient expectations about their private information.

So it was not actually surprising when, in 2018, DeepMind announced that it was stepping away from Streams — handing the app (and all its data) to Google Health — Google’s internal health-focused division — which went on to complete its takeover of DeepMind Health in 2019. (Although it was still shocking, as we opined at the time.)

It was Google Health that Suleyman suggested would be carrying forward the work to bake AI into Streams, writing at the time of the takeover that: “The combined experience, infrastructure and expertise of DeepMind Health teams alongside Google’s will help us continue to develop mobile tools that can support more clinicians, address critical patient safety issues and could, we hope, save thousands of lives globally.”

A particular irony attached to the Google Health takeover bit of the Streams saga is the fact that DeepMind had, when under fire over its intentions toward patient data, claimed people’s medical information would never be touched by its adtech parent.

Until of course it went on it hand the whole project off to Google — and then lauded the transfer as great news for clinicians and patients!

Google’s takeover of Streams meant NHS Trusts that wanted to continue using the app had to ink new contracts directly with Google Health. And all those who had rolled out the app did so. It’s not like they had much choice if they did want to continue.

Again, jump forward a couple of years and it’s Google Health now suddenly facing a major reorg — with Streams in the frame for the chop as part of Google’s perpetually reconfiguring project priorities.

It is quite the ignominious ending to an already infamous project.

DeepMind’s involvement with the NHS had previously been seized upon by the UK government — with former health secretary, Matt Hancock, trumpeting an AI research partnership between the company and Moorfield’s Eye Hospital as an exemplar of the kind of data-driven innovation he suggested would transform healthcare service provision in the UK.

Luckily for Hancock he didn’t pick Streams as his example of great “healthtech” innovation. (Moorfields confirmed to us that its research-focused partnership with Google Health is continuing.)

The hard lesson here appears to be don’t bet the nation’s health on an adtech giant that plays fast and loose with people’s data and doesn’t think twice about pulling the plug on digital medical devices as internal politics dictate another chair-shuffling reorg.

Patient data privacy advocacy group, MedConfidential — a key force in warning over the scope of the Royal Free’s DeepMind data-sharing deal — urged Google to ditch the spin and come clean about the Streams cock-up, once and for all.

“Streams is the Windows Vista of Google — a legacy it hopes to forget,” MedConfidential’s Sam Smith told us. “The NHS relies on trustworthy suppliers, but companies that move on after breaking things create legacy problems for the NHS, as we saw with wannacry. Google should admit the decision, delete the data, and learn that experimenting on patients is regulated for a reason.”

Questions over Royal Free’s ongoing app use

Despite the Information Commissioner’s Office’s 2017 finding that the Royal Free’s original data-sharing deal with DeepMind was improper, it’s notable that the London Trust stuck with Streams — continuing to pass data to DeepMind.

The original patient data-set that was shared with DeepMind without a valid legal basis was never ordered to be deleted. Nor — presumably has it since been deleted. Hence the call for Google to delete the data now.

Ironically the improperly acquired data should (in theory) finally get deleted — once contractual timeframes for any final back-up purges elapse — but only because it’s Google itself planning to switch off Streams.

The Royal Free confirmed to us that it is still using Streams, even as Google spins the dial on its commercial priorities for the umpteenth time and decides it’s not interested in this particular bit of clinician support, after all.

We put a number of questions to the Trust — including about the deletion of patient data — none of which it responded to.

Instead, two days later, it sent us this one-line statement which raises plenty more questions — saying only that: “The Streams app has not been decommissioned for the Royal Free London and our clinicians continue to use it for the benefit of patients in our hospitals.”

It is not clear how long the Trust will be able to use an app Google is decommissioning. Nor how wise that might be for patient safety — such as if the app won’t get necessary security updates, for example.

We’ve also asked Google how long it will continue to support the Royal Free’s usage — and when it plans to finally switch off the service. As well as which internal group will be responsible for any SLA requests coming from the Royal Free as the Trust continues to use software Google Health is decommissioning — and will update this report with any response. (Earlier a Google spokeswoman told us the Royal Free would continue to use Streams for the ‘near future’ — but she did not offer a specific end date.)

In press reports this month on the Google Health reorg — covering an internal memo first obtained by Business Insider —  teams working on various Google health projects were reported to be being split up to other areas, including some set to report into Google’s search and AI teams.

So which Google group will take over responsibility for the handling of the SLA with the Royal Free, as a result of the Google Health reshuffle, is an interesting question.

In earlier comments, Google’s spokeswoman told us the new structure for its reconfigured health efforts — which are still being badged ‘Google Health’ — will encompass all its work in health and wellness, including Fitbit, as well as AI health research, Google Cloud and more.

On Streams specifically, she said the app hasn’t made the cut because when Google assimilated DeepMind Health it decided to focus its efforts on another digital offering for clinicians — called Care Studio — which it’s currently piloting with two US health systems (namely: Ascension & Beth Israel Deaconess Medical Center). 

And anyone who’s ever tried to use a Google messaging app will surely have strong feelings of déjà vu on reading that…

DeepMind’s co-founder, meanwhile, appears to have remained blissfully ignorant of Google’s intentions to ditch Streams in favor of Care Studio — tweeting back in 2019 as Google completed the takeover of DeepMind Health that he had been “proud to be part of this journey”, and also touting “huge progress delivered already, and so much more to come for this incredible team”.

In the end, Streams isn’t being ‘supercharged’ (or levelled up to use current faddish political parlance) with AI — as his 2019 blog post had envisaged — Google is simply taking it out of service. Like it did with Reader or Allo or Tango or Google Play Music, or…. well, the list goes on.

Suleyman’s own story contains some wrinkles, too.

He is no longer at DeepMind but has himself been ‘folded into’ Google — joining as a VP of artificial intelligence policy, after initially being placed on an extended leave of absence from DeepMind.

In January, allegations that he had bullied staff were reported by the WSJ. And then, earlier this month, Business Insider expanded on that — reporting follow up allegations that there had been confidential settlements between DeepMind and former employees who had worked under Suleyman and complained about his conduct (although DeepMind denied any knowledge of such settlements).

In a statement to Business Insider, Suleyman apologized for his past behavior — and said that in 2019 he had “accepted feedback that, as a co-founder at DeepMind, I drove people too hard and at times my management style was not constructive”, adding that he had taken time out to start working with a coach and that that process had helped him “reflect, grow and learn personally and professionally”.

We asked Google if Suleyman would like to comment on the demise of Streams — and on his employer’s decision to kill the project — given his high hopes for the project and all the years of work he put into the health push. But the company did not engage with that request.

We also offered Suleyman the chance to comment directly. We’ll update this story if he responds.

Virtual clinic Hey Jane raises $2.2M to solve for state anti-abortion legislation

By Christine Hall

As more states pass some type of abortion ban, Hey Jane, a virtual clinic startup offering telemedicine abortion care, announced Thursday that it raised $2.2 million in an oversubscribed round from a group of investors, including Koa Lab, Gaingels and Foursight Capital Partners.

The idea for the remote-first company stemmed from a conversation in 2019 that founder and CEO Kiki Freedman had with some friends regarding Missouri being one of six states that has one abortion clinic left. Freedman, who goes by a nickname to avoid violence against abortion providers, explained that, in fact, the clinic was slated for closure that summer, which would have meant Missouri was the first state to not have any abortion care. The clinic was ultimately able to stay open.

“Many of the digital health clinics I saw were focused on men’s wellness and didn’t talk about women’s health,” Freedman told TechCrunch. “I thought this virtual model could be used for safe and discreet abortion care.”

One of Hey Jane’s investors, who wished to remain publicly anonymous, “was excited to invest in Freedman and Hey Jane” because he agreed — women’s health was an underserved category. Unlike men’s healthcare, abortion care is segregated from women’s health care. This stemmed from Reagan’s mandates separating abortion care from hospitals.

One in four women will have an abortion by age 45, according to Planned Parenthood. However, just in 2021, over 90 abortion restrictions were enacted in the United States, and there are 1,320 restrictions in total, according to The Guttmacher Institute, a nonprofit research and policy organization committed to advancing sexual and reproductive health and rights. Currently, Arkansas and Oklahoma have near-total abortion bans except when a patient’s life is endangered. Meanwhile, Idaho, South Carolina and Texas ban abortion at either six weeks or with very limited exceptions.

In July 2020, a federal judge granted approval for women to obtain abortion medication without having to see a doctor, which opened the door for companies, like Hey Jane and others, to begin offering “no touch” services for people who were less than 10 weeks pregnant.

The $249 treatment includes screening by a medical doctor, FDA-approved medication prescribed and shipped overnight to the person’s house, follow-up virtual visits and the ability to chat with a doctor during the entire process. The Hey Jane team also checks in frequently with the patient via text message.

The company said removing financial barriers is “a huge priority for us.” Though the company does not accept insurance yet, it is offering financial assistance through a nonprofit abortion fund partner, Reprocare. This organization subsidizes up to $110 of the $249 treatment so that patients can pay as little as $139 for treatment.

The new funding will enable Hey Jane to expand into new states and add to its team of seven to build out the product and automated process and for legal research so the company can stay abreast of telemedicine laws and telemedicine abortion laws for each state.

There are several regulatory requirements Hey Jane must follow in each state, including ensuring that clinicians only provide care to patients in states in which they’re licensed. For this reason, the company has clinicians licensed in each state in which it operates who are ready to prescribe medication when appropriate. It also has on-demand experts for emotional relief.

Hey Jane just launched across California this week and is also in New York and Washington. This means that Hey Jane’s service areas now cover up to 34% of all abortions performed annually in the United States, Freedman said. Those states were chosen first because California and New York have the highest number of abortions performed annually, she added.

“Although people in those states may have easier access to clinics, they could still strongly benefit from treatment with Hey Jane since it’s as safe and effective and half the price of in-clinic care,” Freedman said. “It doesn’t require costs, or time for travel or child care, ensures privacy and discretion and provides additional layers of emotional support.”

At the time of press, the company was in the process of going live in Connecticut, and Freedman expects to be in 10 states by the end of the year.

Freedman plans to be able to offer treatment in all 50 states in coming years. However, there are regulatory barriers limiting access to telemedicine abortion in 19 states. Hey Jane is partnering with the Advancing New Standards in Reproductive Health research group out of the University of California at San Francisco to gather information to this end.

“We are working with leading researchers to expand the ample existing evidence that this modality of care is safe, effective and preferred by patients,” she added. “We hope this research can further advance discussions in more restrictive states, ultimately leading to much needed, patient-centric updates to outdated regulations. Existing data on the safety and effectiveness of telemedicine abortion paints a very clear picture that this is the future of abortion care.”

The company is currently seeing 250% quarterly growth in the number of patients using the service. As it has grown, it is focusing more on additional tools for coordinated care and new products.

Abortions are often kept secret due to worries of judgment and discrimination, and Hey Jane will provide a much-needed outlet for patients to discreetly share their experiences and emotion, Freedman said.

“We are focusing on convenience and privacy,” she added. “Two-thirds of women don’t want to talk about their experience, so we want to provide a space for them.”

Matters of women’s health are highly personal. If you or someone you know is struggling with a private women’s health concern, please contact your primary care physician or secular community health clinic for more information.

Back to the suture: The future of healthcare is in the home

By Ram Iyer
Sumi Das Contributor
Sumi Das is a partner at CapitalG, Alphabet’s independent growth fund, where he leads healthcare tech and consumer fintech investments. Prior investments include Robinhood, Stripe, Convoy, Albert, Aye Finance, Next Insurance and Strive Health.
Nina Gerson Contributor
Nina Gerson is a vice president at CapitalG, Alphabet’s independent growth fund, where she co-leads healthcare tech investments. Prior investments include Strive Health and Next Insurance.

The pandemic has highlighted some of the brightest spots — and greatest areas of need — in America’s healthcare system. On one hand, we’ve witnessed the vibrancy of America’s innovation engine, with notable contributions by U.S.-based scientists and companies for vaccines and treatments.

On the other hand, the pandemic has highlighted both the distribution challenges and cost inefficiencies of the healthcare system, which now accounts for nearly a fifth of our GDP — far more than any other country — yet lags many other developed nations in clinical outcomes.

Many of these challenges stem from a lack of alignment between payment and incentive models, as well as an overreliance on hospitals as centers for care delivery. A third of healthcare costs are incurred at hospitals, though at-home models can be more effective and affordable. Furthermore, most providers rely on fee for service instead of preventive care arrangements.

These factors combine to make care in this country reactive, transactional and inefficient. We can improve both outcomes and costs by moving care from the hospital back to the place it started — at home.

Right now in-home care accounts for only 3% of the healthcare market. We predict that it will grow to 10% or more within the next decade.

In-home care is nothing new. In the 1930s, over 40% of physician-patient encounters took place in the home, but by the 1980s, that figure dropped to under 1%, driven by changes in health economics and technologies that led to today’s hospital-dominant model of care.

That 50-year shift consolidated costs, centralized access to specialized diagnostics and treatments, and created centers of excellence. It also created a transition from proactive to reactive care, eliminating the longitudinal relationship between patient and provider. In today’s system, patients are often diagnosed by and receive treatment from individual doctors who do not consult one another. These highly siloed treatments often take place only after the patient needs emergency care. This creates higher costs — and worse outcomes.

That’s where in-home care can help. Right now in-home care accounts for only 3% of the healthcare market. We predict that it will grow to 10% or more within the next decade. This growth will improve the patient experience, achieve better clinical outcomes and reduce healthcare costs.

To make these improvements, in-home healthcare strategies will need to leverage next-generation technology and value-based care strategies. Fortunately, the window of opportunity for change is open right now.

Five factors driving the opportunity for change

Over the last few years, five significant innovations have created new incentives to drive dramatic changes in the way care is delivered.

  1. Technologies like remote patient monitoring (RPM) and telemedicine have matured to a point that can be deployed at scale. These technologies enable providers to remotely manage patients in a proactive, long-term relationship from the comfort of their homes and at a reduced cost.

Y Combinator-backed Adra wants to turn all dentists into cavity-finding ‘super dentists’

By Christine Hall

Like other areas of healthcare, the dental industry is steadily embracing technology. But while much of it is in the orthodontic realm, other startups, like Adra, are bringing artificial intelligence into a dentist’s day-to-day workflow, particularly in finding cavities, of what will be a $435.08 billion global dental services market this year.

The Singapore-based company was founded in 2021, but was an idea that started last year. Co-founder Hamed Fesharaki has been a dentist for over a decade and owns two clinics in Singapore.

He said dentists learn to read X-rays in dental school, but it can take a few years to get good at it. Dentists also often have just minutes to read them as they hop between patients.

As a result, dentists end up misdiagnosing cavities up to 40% of the time, co-founder Yasaman Nemat said. Her background is in imaging, where she developed an artificial intelligence machine identifying hard-to-see cancers, something Fesharaki thought could also be applied to dental medicine.

Providing the perspective of a more experienced dentist, Adra’s intent is to make every dentist “a super dentist,” Fesharaki told TechCrunch. Its software detects cavities and other dental problems on dental X-rays faster and 25% more accurately, so that clinics can use that time to better serve patients and increase revenue.

Example of Adra’s software. Image Credits: Adra

“We are coming from the eye of an experienced dentist to help illustrate the problems by turning the X-rays into images to better understand what to look for,” he added. “Ultimately, the dentist has the final say, but we bring the experience element to help them compare and give them suggestions.”

By quickly pointing out the problem and the extent of it, dentists can decide in what way they want to treat it — for example, do a filling, a fluoride treatment or wait.

Along with third co-founder Shifeng Chen, the company is finishing up its time in Y Combinator’s summer cohort and has raised $250,000 so far. Fesharaki intends to do more formalized seed fundraising and wants to bring on more engineers to tackle user experience and add more features.

The company has a few clinics doing pilots and wants to attract more as it moves toward a U.S. Food and Drug Administration clearance. Fesharaki expects it to take six to nine months to receive the clearance, and then Adra will be able to hit the market in late 2022 or early 2023.

This Week in Apps: OnlyFans bans sexual content, SharePlay delayed, TikTok questioned over biometric data collection

By Sarah Perez

Welcome back to This Week in Apps, the weekly TechCrunch series that recaps the latest in mobile OS news, mobile applications and the overall app economy.

The app industry continues to grow, with a record 218 billion downloads and $143 billion in global consumer spend in 2020. Consumers last year also spent 3.5 trillion minutes using apps on Android devices alone. And in the U.S., app usage surged ahead of the time spent watching live TV. Currently, the average American watches 3.7 hours of live TV per day, but now spends four hours per day on their mobile devices.

Apps aren’t just a way to pass idle hours — they’re also a big business. In 2019, mobile-first companies had a combined $544 billion valuation, 6.5x higher than those without a mobile focus. In 2020, investors poured $73 billion in capital into mobile companies — a figure that’s up 27% year-over-year.

This Week in Apps offers a way to keep up with this fast-moving industry in one place with the latest from the world of apps, including news, updates, startup fundings, mergers and acquisitions, and suggestions about new apps and games to try, too.

Do you want This Week in Apps in your inbox every Saturday? Sign up here: techcrunch.com/newsletters

Top Stories

OnlyFans to ban sexually explicit content

OnlyFans logo displayed on a phone screen and a website

(Photo Illustration by Jakub Porzycki/NurPhoto via Getty Images)

Creator platform OnlyFans is getting out of the porn business. The company announced this week it will begin to prohibit any “sexually explicit” content starting on October 1, 2021 — a decision it claimed would ensure the long-term sustainability of the platform. The news angered a number of impacted creators who weren’t notified ahead of time and who’ve come to rely on OnlyFans as their main source of income.

However, word is that OnlyFans was struggling to find outside investors, despite its sizable user base, due to the adult content it hosts. Some VC firms are prohibited from investing in adult content businesses, while others may be concerned over other matters — like how NSFW content could have limited interest from advertisers and brand partners. They may have also worried about OnlyFans’ ability to successfully restrict minors from using the app, in light of what appears to be soon-to-come increased regulations for online businesses. Plus, porn companies face a number of other issues, too. They have to continually ensure they’re not hosting illegal content like child sex abuse material, revenge porn or content from sex trafficking victims — the latter which has led to lawsuits at other large porn companies.

The news followed a big marketing push for OnlyFans’ porn-free (SFW) app, OFTV, which circulated alongside reports that the company was looking to raise funds at a $1 billion+ valuation. OnlyFans may not have technically needed the funding to operate its current business — it handled more than $2 billion in sales in 2020 and keeps 20%. Rather, the company may have seen there’s more opportunity to cater to the “SFW” creator community, now that it has big names like Bella Thorne, Cardi B, Tyga, Tyler Posey, Blac Chyna, Bhad Bhabie and others on board.

U.S. lawmakers demand info on TikTok’s plans for biometric data collection

The TikTok logo is seen on an iPhone 11 Pro max

The TikTok logo is seen on an iPhone 11 Pro max. Image Credits: Nur Photo/Getty Images

U.S. lawmakers are challenging TikTok on its plans to collect biometric data from its users. TechCrunch first reported on TikTok’s updated privacy policy in June, where the company gave itself permission to collect biometric data in the U.S., including users’ “faceprints and voiceprints.” When reached for comment, TikTok could not confirm what product developments necessitated the addition of biometric data to its list of disclosures about the information it automatically collects from users, but said it would ask for consent in the case such data collection practices began.

Earlier this month, Senators Amy Klobuchar (D-MN) and John Thune (R-SD) sent a letter to TikTok CEO Shou Zi Chew, which said they were “alarmed” by the change, and demanded to know what information TikTok will be collecting and what it plans to do with the data. This wouldn’t be the first time TikTok got in trouble for excessive data collection. Earlier this year, the company paid out $92 million to settle a class-action lawsuit that claimed TikTok had unlawfully collected users’ biometric data and shared it with third parties.

Weekly News

Platforms: Apple

Image Credits: Apple

  • ⭐ Apple told developers that some of the features it announced as coming in iOS 15 won’t be available at launch. This includes one of the highlights of the new OS, SharePlay, a feature that lets people share music, videos and their screen over FaceTime calls. Other features that will come in later releases include Wallet’s support for ID cards, the App Privacy report and others that have yet to make it to beta releases.
  • Apple walked back its controversial Safari changes with the iOS 15 beta 6 update. Apple’s original redesign had shown the address bar at the bottom of the screen, floating atop the page’s content. Now the tab bar will appear below the page’s content, offering access to its usual set of buttons as when it was at the top. Users can also turn off the bottom tab bar now and revert to the old, Single Tab option that puts the address bar back at the top as before.
  • In response to criticism over its new CSAM detection technology, Apple said the version of NeuralHash that was reverse-engineered by a developer, Asuhariet Ygvar, was a generic version, and not the complete version that will roll out later this year.
  • The Verge dug through over 800 documents from the Apple-Epic trial to find the best emails, which included dirt on a number of other companies like Netflix, Hulu, Sony, Google, Nintendo, Valve, Microsoft, Amazon and more. These offered details on things like Netflix’s secret arrangement to pay only 15% of revenue, how Microsoft also quietly offers a way for some companies to bypass its full cut, how Apple initially saw the Amazon Appstore as a threat and more.

Platforms: Google

  • A beta version of the Android Accessibility Suite app (12.0.0) which rolled out with the fourth Android beta release added something called “Camera Switches” to Switch Access, a toolset that lets you interact with your device without using the touchscreen. Camera Switches allows users to navigate their phone and use its features by making face gestures, like a smile, open mouth, raised eyebrows and more.
  • Google announced its Pixel 5a with 5G, the latest A-series Pixel phone, will arrive on August 27, offering IP67 water resistance, long-lasting Adaptive Battery, Pixel’s dual-camera system and more, for $449. The phone makes Google’s default Android experience available at a lower price point than the soon to arrive Pixel 6.
  • An unredacted complaint from the Apple-Epic trial revealed that Google had quietly paid developers hundreds of millions of dollars via a program known as “Project Hug,” (later “Apps and Games Velocity Program”) to keep their games on the Play Store. Epic alleges Google launched the program to keep developers from following its lead by moving their games outside the store.

Augmented Reality

  • Snap on Thursday announced it hired its first VP of Platform Partnerships to lead AR, Konstantinos Papamiltiadis (“KP”). The new exec will lead Snap’s efforts to onboard partners, including individual AR creators building via Lens Studio as well as large companies that incorporate Snapchat’s camera and AR technology (Camera Kit) into their apps. KP will join in September, and report to Ben Schwerin, SVP of Content and Partnerships.

Fintech

  • Crypto exchange Coinbase will enter the Japanese market through a new partnership with Japanese financial giant Mitsubishi UFJ Financial Group (MUFG). The company said it plans to launch other localized versions of its existing global services in the future.

Social

Image Credits: Facebook

  • Facebook launched a “test” of Facebook Reels in the U.S. on iOS and Android. The new feature brings the Reels experience to Facebook, allowing users to create and share short-form video content directly within the News Feed or within Facebook Groups. Instagram Reels creators can also now opt in to have their Reels featured on users’ News Feed. The company is heavily investing its its battle with TikTok, even pledging that some portion of its $1 billion creator fund will go toward Facebook Reels.
  • Twitter’s redesign of its website and app was met with a lot of backlash from users and accessibility experts alike. The company choices add more visual contrast between various elements and may have helped those with low vision. But for others, the contrast is causing strain and headaches. Experts believe accessibility isn’t a one-size fits all situation, and Twitter should have introduced tools that allowed people to adjust their settings to their own needs.
  • The pro-Trump Twitter alternative Gettr’s lack of moderation has allowed users to share child exploitation images, according to research from the Stanford Internet Observatory’s Cyber Policy Center.
  • Pinterest rolled out a new set of more inclusive search filters that allow people to find styles for different types of hair textures — like coily, curly, wavy, straight, as well as shaved or bald and protective styles. 

Photos

  • Photoshop for iPad gained new image correction tools, including the Healing Brush and Magic Wand, and added support for connecting an iPad to external monitors via HDMI or USB-C. The company also launched a Photoshop Beta program on the desktop.

Messaging

  • WhatsApp is being adopted by the Taliban to spread its message across Afghanistan, despite being on Facebook’s list of banned organizations. The company says it’s proactively removing Taliban content — but that may be difficult to do since WhatsApp’s E2E encryption means it can’t read people’s texts. This week, Facebook shut down a Taliban helpline in Kabul, which allowed civilians to report violence and looting, but some critics said this wasn’t actually helping local Afghans, as the group was now in effect governing the region.
  • WhatsApp is also testing a new feature that will show a large preview when sharing links, which some suspect may launch around the time when the app adds the ability to have the same account running on multiple devices.

Streaming & Entertainment

  • Netflix announced it’s adding spatial audio support on iPhone and iPad on iOS 14, joining other streamers like HBO Max, Disney+ and Peacock that have already pledged to support the new technology. The feature will be available to toggle on and off in the Control Center, when it arrives.
  • Blockchain-powered streaming music service Audius partnered with TikTok to allow artists to upload their songs using TikTok’s new SoundKit in just one click.
  • YouTube’s mobile app added new functionality that allows users to browse a video’s chapters, and jump into the chapter they want directly from the search page.
  • Spotify’s Anchor app now allows users in global markets to record “Music + Talk” podcasts, where users can combine spoken word recordings with any track from Spotify’s library of 70 million songs for a radio DJ-like experience.
  • Podcasters are complaining that Apple’s revamped Podcasts platform is not working well, reports The Verge. Podcasts Connect has been buggy, and sports a confusing interface that has led to serious user errors (like entire shows being archived). And listeners have complained about syncing problems and podcasts they already heard flooding their libraries.

Dating

  • Tinder announced a new feature that will allow users to voluntarily verify their identity on the platform, which will allow the company to cross-reference sex offender registry data. Previously, Tinder would only check this database when a user signed up for a paid subscription with a credit card.

Gaming

Image Source: The Pokémon Company

  • Pokémon Unite will come to iOS and Android on September 22, The Pokémon Company announced during a livestream this week. The strategic battle game first launched on Nintendo Switch in late July.
  • Developer Konami announced a new game, Castlevania: Grimoire of Souls, which will come exclusively to Apple Arcade. The game is described as a “full-fledged side-scrolling action game,” featuring a roster of iconic characters from the classic game series. The company last year released another version of Castelvania on the App Store and Google Play.
  • Dragon Ball Z: Dokkan Battle has now surpassed $3 billion in player spending since its 2015 debut, reported Sensor Tower. The game from Bandai Namco took 20 months to reach the figure after hitting the $2 billion milestone in 2019. The new landmark sees the game joining other top-grossers, including Clash Royale, Lineage M and others.
  • Sensor Tower’s mobile gaming advertising report revealed data on top ad networks in the mobile gaming market, and their market share. It also found puzzle games were among the top advertisers on gaming-focused networks like Chartboost, Unity, IronSource and Vungle. On less game-focused networks, mid-core games were top titles, like Call of Duty: Mobile and Top War. 

Image Credits: Sensor Tower

Health & Fitness

  • Apple is reportedly scaling back HealthHabit, an internal app for Apple employees that allowed them to track fitness goals, talk to clinicians and coaches at AC Wellness (a doctors’ group Apple works with) and manage hypertension. According to Insider, 50 employees had been tasked to work on the project.
  • Samsung launched a new product for Galaxy smartphones in partnership with healthcare nonprofit The Commons Project, that allows U.S. users to save a verifiable copy of their vaccination card in the Samsung Pay digital wallet.

Image Credits: Samsung

Adtech

Government & Policy

  • China cited 43 apps, including Tencent’s WeChat and an e-reader from Alibaba, for illegally transferring user data. The regulator said the apps had transferred users location data and contact list and harassed them with pop-up windows. The apps have until August 25 to make changes before being punished.

Security & Privacy

  • A VICE report reveals a fascinating story about a jailbreaking community member who had served as a double agent by spying for Apple’s security team. Andrey Shumeyko, whose online handles included JVHResearch and YRH04E, would advertise leaked apps, manuals and stolen devices on Twitter and Discord. He would then tell Apple things like which Apple employees were leaking confidential info, which reporters would talk to leakers, who sold stolen iPhone prototypes and more. Shumeyko decided to share his story because he felt Apple took advantage of him and didn’t compensate him for the work.

Funding and M&A

💰 South Korea’s GS Retail Co. Ltd will buy Delivery Hero’s food delivery app Yogiyo in a deal valued at 800 billion won ($685 million USD). Yogiyo is the second-largest food delivery app in South Korea, with a 25% market share.

💰 Gaming platform Roblox acquired a Discord rival, Guilded, which allows users to have text and voice conversations, organize communities around events and calendars and more. Deal terms were not disclosed. Guilded raised $10.2 million in venture funding. Roblox’s stock fell by 7% after the company reported earnings this week, after failing to meet Wall Street expectations.

💰 Travel app Hopper raised $175 million in a Series G round of funding led by GPI Capital, valuing the business at over $3.5 billion. The company raised a similar amount just last year, but is now benefiting from renewed growth in travel following COVID-19 vaccinations and lifting restrictions.

💰 Indian quiz app maker Zupee raised $30 million in a Series B round of funding led by Silicon Valley-based WestCap Group and Tomales Bay Capital. The round values the company at $500 million, up 5x from last year.

💰 Danggeun Market, the publisher of South Korea’s hyperlocal community app Karrot, raised $162 million in a Series D round of funding led by DST Global. The round values the business at $2.7 billion and will be used to help the company launch its own payments platform, Karrot Pay.

💰 Bangalore-based fintech app Smallcase raised $40 million in Series C funding round led by Faering Capital and Premji Invest, with participation from existing investors, as well as Amazon. The Robinhood-like app has over 3 million users who are transacting about $2.5 billion per year.

💰 Social listening app Earbuds raised $3 million in Series A funding led by Ecliptic Capital. Founded by NFL star Jason Fox, the app lets anyone share their favorite playlists, livestream music like a DJ or comment on others’ music picks.

💰 U.S. neobank app One raised $40 million in Series B funding led by Progressive Investment Company (the insurance giant’s investment arm), bringing its total raise to date to $66 million. The app offers all-in-one banking services and budgeting tools aimed at middle-income households who manage their finances on a weekly basis.

Public Markets

📈Indian travel booking app ixigo is looking to raise Rs 1,600 crore in its initial public offering, The Economic Times reported this week.

📉Trading app Robinhood disappointed in its first quarterly earnings as a publicly traded company, when it posted a net loss of $502 million, or $2.16 per share, larger than Wall Street forecasts. This overshadowed its beat on revenue ($565 million versus $521.8 million expected) and its more than doubling of MAUs to 21.3 million in Q2.  Also of note, the company said dogecoin made up 62% of its crypto revenue in Q2.

Downloads

Polycam (update)

Image Credits: Polycam

3D scanning software maker Polycam launched a new 3D capture tool, Photo Mode, that allows iPhone and iPad users to capture professional-quality 3D models with just an iPhone. While the app’s scanner before had required the use of the lidar sensor built into newer devices like the iPhone 12 Pro and iPad Pro models, the new Photo Mode feature uses just an iPhone’s camera. The resulting 3D assets are ready to use in a variety of applications, including 3D art, gaming, AR/VR and e-commerce. Data export is available in over a dozen file formats, including .obj, .gtlf, .usdz and others. The app is a free download on the App Store, with in-app purchases available.

Jiobit (update)

Jiobit, the tracking dongle acquired by family safety and communication app Life360, this week partnered with emergency response service Noonlight to offer Jiobit Protect, a premium add-on that offers Jiobit users access to an SOS Mode and Alert Button that work with the Jiobit mobile app. SOS Mode can be triggered by a child’s caregiver when they detect — through notifications from the Jiobit app — that a loved one may be in danger. They can then reach Noonlight’s dispatcher who can facilitate a call to 911 and provide the exact location of the person wearing the Jiobit device, as well as share other details, like allergies or special needs, for example.

Tweets

When your app redesign goes wrong…

Image Credits: Twitter.com

Prominent App Store critic Kosta Eleftheriou shut down his FlickType iOS app this week after too many frustrations with App Review. He cited rejections that incorrectly argued that his app required more access than it did — something he had successfully appealed and overturned years ago. Attempted follow-ups with Apple were ignored, he said. 

Image Credits: Twitter.com

Anyone have app ideas?

Medical supply marketplace startup bttn. sews up additional $5M seed

By Christine Hall

Coming off a $1.5 million seed round in June, bttn. announced Thursday that it secured another $5 million extension, led by FUSE, to the round to give it a $26.5 million post-money valuation.

The Seattle-based company was founded in March 2021 by JT Garwood and Jack Miller after seeing the challenges medical organizations had during the global pandemic to not only find supplies, but also get fair prices for them.

“We went into this building on the pain points customers had dealing with a system that is so archaic and outdated — most were still faxing in order forms and keeping closets full of supplies, but not knowing what was there,” Garwood, CEO, told TechCrunch.

Bttn. is going after the U.S. wholesale medical supply market, which is predicted to be valued at $243.3 billion by the end of 2021, according to IBISWorld. The company created a business-to-business e-commerce platform with a variety of high-quality medical supplies, saving customers an average of between 20% and 40%, while providing a better ordering and shipping experience, Garwood said.

It now boasts more than 300 customers, including individual practices and surgical centers, and multiple government contracts. It is also currently the preferred supplier for over 17 healthcare associations across the country, Garwood said. In addition to expanding into dental supplies, bttn. is also attracting customers like senior living facilities and home and hospice care.

Garwood intends to use the funds to expand bttn.’s technology, sales and operations teams, and increase its partnerships. The company is also adding new features like a portal to track shipments more easily, better order automation and improve the ability to control when supplies will get to them.

Bttn. is also analyzing more of the data coming in from its marketplace to recognize where the trends are coming from, including hospitalization rates, to share with customers. For example, if hospitals are overcrowded, supply shortages will follow, Garwood said.

“The medical supply industry was built on inequity, and we have a sense of duty to build a product that enables a better future for our customers,” he added. “We can proactively let customers know that spikes are expected, provide them with correct information and give that power back to the consumers and healthcare providers in ways they never had before.”

Whereas bttn.’s first seed round was “about pouring gas on the fire,” partnering with FUSE this time around was an easy decision for Garwood, who said the firm is bringing new assets to the table.

Brendan Wales, general partner at FUSE, said via email that his firm backs promising entrepreneurs building businesses in the Pacific Northwest and discovered bttn. before they announced any funding.

He said there is massive consumerization of healthcare, most evident on the patient side for years, but now becoming so on the provider side. Medical office employees are looking for the same type of customer experience they get from online businesses they frequently shop at, and bttn. “has a relentless drive to provide the same type of experiences and interactions to health providers.”

“We fell in love with the idea of providing a transparent and delightful customer experience to health providers, something that has been sorely lacking,” Wales added. “That, tied in with a young and ambitious team, made it so that our entire partnership worked tirelessly to partner with them.”

 

How to establish a health tech startup advisory board

By Annie Siebert
Patrick Frank Contributor
Patrick Frank is the co-founder and COO of PatientPartner, a platform that connects pre-surgical patients with fully recovered patients who went through the same surgery. Frank has worked in consumer technology across industries including retail banking, law, real estate and healthcare.

When you enter the health tech industry as a new startup, an advisory board is a crucial foundational step. A board can guide you through industry-specific nuances, help you make important decisions and prove your legitimacy to investors looking for a strong industry background.

An advisory board will be able to give you strategic insights about both your company and the wider healthcare and technology industries.

In my experience of raising capital, the unpredictable financial situation at the beginning of the pandemic meant we nearly lost our $2 million round, but came through with a committed $250,000, which we used to bring in about $500,000 in revenue.

Something that helped this process was building our advisory board and starting small — we didn’t go for all of healthcare but instead focused on two healthcare verticals. This allowed us to prove our concept, build case studies and win contracts with specific teams in our customers’ companies.

It pays off to stay focused and prove your worth so that your advisory board members can champion you in niche markets, with the potential to expand in the future. For this reason, it’s important to identify the main intention behind your board, and exactly who should be on it.

Who to recruit

Three to five people is an ideal starting point for an advisory board, depending on the size and stage of your company. In health tech, you need more than just the healthcare perspective — you also need the insight of those who have already grown technology companies, perhaps outside of the industry. Our company’s board is an even split of two healthcare and two technology advisers, and, ideally, you want to find a fifth who is well versed in both industries.

It pays off to stay focused and prove your worth so that your advisory board members can champion you in niche markets, with the potential to expand in the future.

An M.D., a Ph.D. from a respected institution or a thought leader in your relevant field of healthcare is the most important asset to an advisory board. These are the highly decorated physicians who have strong connections and act as a reference for their peers.

They provide instant credibility for your company, help you get into the minds of both patients and healthcare providers, and can outline how various health systems work.

The gray revolution: Fundraising within the older adult space

By Annie Siebert
Lawrence Kosick Contributor
Lawrence Kosick is the co-founder of GetSetUp, the largest online learning community designed specifically for older adults.

The technology industry is often thought of as being the domain of the young and the new. We see an emphasis on young founders (“40 Under 40”), innovative ideas and disruptive challenges to legacy brands, incumbent companies and “old” ways of thinking.

But one of the things I’ve learned on my journey in co-founding my latest startup is that technology should be enabling and accessible to all, and nowhere is this more critical than for empowering our older adults.

Older adults are one of the most underrepresented audiences for new technology products and platforms. There is a massive opportunity to provide products and services that will make life better for today’s seniors and future generations of older adults to come. Founders in every space, from edtech to healthcare, from financial services to robotics, can make a bigger impact if we recognize the opportunity of being of service to older adults.

One of the best strategies for tech companies that want to serve the older adult market is to focus your value proposition on empowering older adults.

Don’t make a product “for old people”

Older adults often get overlooked by tech companies. In fairness, it can be hard (and insensitive and uninspiring) to market products and services as being “for old people,” because people in this group don’t tend to think of themselves as “old.”

One of the best strategies for tech companies that want to serve the older adult market is to focus your value proposition on empowering older adults. Don’t make a product “for old people” — make a product that helps older adults lead a healthier, more active, more connected life.

Whether it’s the education tech space, financial services, health tech, consumer products or other innovative digital services for seniors, tech companies have big opportunities to empower older adults.

We are seeing some great examples, including:

  • AgeBold is doing interesting work with at-home exercise programs for older adults to improve their balance, strength and mobility. The value proposition: Exercise for better aging. It’s a product “for” older adults, but the message is focused on empowerment and building strength, helping people live healthier, more active lives as they age.
  • Eldera.ai connects children with vetted older adult mentors, for one-on-one or group conversations and remote learning activities. This concept is powerful because it helps older adults share their life experience and build relationships with other families.

Older adults have so much to offer. Instead of approaching this market as a “problem” to be solved, startups should engage with older adults as an active, curious, ready-to-learn group of people who are eager to be empowered.

Recognize the size of the opportunity of the older adult market

It often seems like so many consumer-facing apps today are created for younger people. But there’s a big disconnect between where so much of the tech industry’s attention and investment is going and the spending power and lifestyle preferences of today’s older adults.

Older adults are the most underserved demographic for the tech world. They’re also one of the fastest-growing age cohorts. The number of people worldwide who are 65 and older is expected to grow from 524 million in 2010 to 1.5 billion in 2050.

The “silver economy,” driven by the spending power of older adults, is expected to grow into the 2030s because the senior population is the wealthiest age group and their numbers are growing 3.2% per year (compared with 0.8% for the overall population).

BoxGroup closes on $255M across two funds to back startups at their earliest stages

By Mary Ann Azevedo

BoxGroup has quietly, yet diligently, been funding companies at the early stage for over a decade. The 11-year-old firm in fact was the first investor in Plaid, a fintech company that nearly got sold to Visa last year for billions of dollars.

It has seen a number of impressive exits over the years, proving an eye that can detect winners before the winners themselves may even realize it. In fact, it’s that early faith in companies that partner David Tisch believes has been key to BoxGroup’s success.

“If you’re starting a company and you’re going to raise money, that first yes is the hardest. And it’s that’s the one that gives you the confidence, the excitement – to know that there’s somebody out there that’s going to believe in this and give you money for it,” Partner David Tisch told TechCrunch. “We really do try to pride ourselves on being that first yes on a regular basis. So the earlier we meet companies, the better.”

Today, BoxGroup is announcing it has beefed up its war chest so that it can be that “first yes” to more companies with the closure of two new funds totaling $255 million of capital. BoxGroup Five is the firm’s fifth early stage fund, and is aimed at investing in emerging tech companies at the pre-seed and seed stages. BoxGroup Strive is its second opportunity fund that will back companies in their subsequent follow-on rounds. Each fund amounts to $127.5 million. 

Over the years, BoxGroup has made over 300 investments including having invested in the earliest rounds of Ro, Plaid, Airtable, Workrise, Scopely, Bowery Farms, Ramp, Titan, Warby Parker, Classpass, Guideline and Glossier. It has had a number of impressive exits in Flatiron Health, PillPack, Matterport, Oscar, Mirror, Bark, Bread and Trello. 

Besides being the first firm to write Plaid a check, BoxGroup was also the first investor in PillPack, which ended up selling to Amazon for just under $1 billion in 2018.

BoxGroup Five – the firm’s early-stage fund – will invest in about 40 to 50 new companies a year with investments ranging from $250,000 to $1 million.

“We want to be the second or third biggest check in a round,” Tisch said.

Image Credits: BoxGroup; Adam Rothenberg (left), Nimi Katragadda (bottom), Greg Rosen (top), David Tisch (right)

The opportunity fund occasionally makes later-stage investments in new companies, but mostly just continues to support companies it invested in at an earlier stage. For example, BoxGroup first invested in id.me in 2010.

“The company is sort of an 11-year overnight success that we’ve been backing for over a decade now,” Tisch said. “It’s an example of us just continuing to support companies through their life cycle.”

BoxGroup also pre-seeded digital healthcare startup Ro, but also funded every round it’s raised since, including its most recent $500 million funding at a $5 billion valuation

Tisch describes the BoxGroup six-person team as “generalists” in terms of the spaces it invests in, with a portfolio consisting of startups in the consumer, enterprise, fintech, healthcare, marketplace, synthetic biology and climate sectors.

Interestingly, BoxGroup’s last fund closures – which totaled $165 million – marked the first time the firm had accepted outside capital in nine years. Prior to that point, it had been funded with only personal capital. Its LPs are a mixed group of endowments, foundations and family offices.

For BoxGroup, building authentic relationships with founders is at the root of what the firm does, says Partner Nimi Katragadda. That includes taking bets on founders, sometimes more than once, even if one of their companies didn’t work out. It means backing just ideas in some cases, and people.

“This cannot be transactional, it has to be personal,” she said. “We want to go on a journey with someone for a decade as they build their business…. We’re comfortable with what early means, including a lot of assumptions, more vision than traction, and raw product.”

Partner Adam Rothenberg agrees, saying: “Our goal is to be the friend in the room. We believe in honesty, tough love, and transparency in building relationships with founders. We focus on the “how” more than the “what” — how a founder thinks, how they will build product, and how they think about attracting talent.”

With offices in San Francisco and New York, the firm will likely be growing in the near future as BoxGroup is looking to add on some “first-line investors,” Tisch said.

Recently, Greg Rosen was named a partner at the firm. Rosen originally joined BoxGroup in 2015, where he spent three years before leaving to join Benchmark. He re-joined BoxGroup in early 2020 and joins the firm’s three other partners: Tisch, Rothenberg and Katragadda. 

While the world of venture is crazy hot right now, Tisch said the firm keeps itself grounded with a wisdom that can only be gained with experience and in time.

“There is seemingly infinite capital waiting to be deployed,” he said. “Without calling the cycle, we know that over time markets go up and down…No matter where we are in a given cycle, smart and determined minds will come together to build important technology companies. Our job is to make sure we are meeting those founders and choosing wisely about which ones to partner with for 10+ year journeys.”

Exo secures $200M toward commercializing ultrasound device

By Christine Hall

Exo, pronounced “echo,” raised a fresh cash infusion of $220 million in Series C financing aimed at commercializing its handheld ultrasound device and point-of-care workflow platform, Exo Works.

The round was led by RA Capital Management, while BlackRock, Sands Capital, Avidity Partners, Pura Vida Investments and prior investors joined in.

The new funding gives the Redwood City, California-based company over $320 million in total investments since the company was founded in 2015, Exo CEO Sandeep Akkaraju told TechCrunch. This includes a $40 million investment raised in 2020.

Ultrasound machines can cost anywhere from $40,000 to $250,000 for low-end technology and into the millions for high-end machines. Meanwhile, Exo’s device will be around the cost of a laptop.

“It is clear to us that ultrasound is the future — it is nonradiating and has no harmful side effects,” Akkaraju said. “We want to take the technology and put it in the palms of physicians. We also want to bring it down to the patient level. The beauty of having this window into the body is you can immediately see things.”

Using a combination of artificial intelligence, medical imaging and silicon technology, the device enables users to use it in a number of real-world medical environments like evaluating cardiology patients or scanning lungs of a COVID-19 patient. It can also be used by patients at home to provide real-time insight following a surgical procedure or to monitor a certain condition.

Exo then adds in its Exo Works, the workflow platform, that streamlines exam review, documentation and billing in under one minute.

Akkaraju said the immediate focus of the company is commercializing the device, which is where most of the new funding will go. He intends to also build out its informatics platform that is being piloted across the country and to ramp up both production and its sales force.

The global point-of-care ultrasound market is expected to reach $3.1 billion by 2025 and will grow 5% annually over that period. In addition to physicians, Akkaraju is hearing from other hospital workers that they, too, want to use the ultrasound device for some of their daily tasks like finding the right vein for an IV.

Once the company’s device is approved by the U.S. Food and Drug Administration, Exo will move forward with its plan to bring the handheld ultrasound device to market.

Zach Scheiner, principal with RA Capital Management, said he met the Exo team in 2020 and RA made its first investment in the Series B extension later that year.

He was “immediately compelled” by the technology and the opportunity to scale. Scheiner also got to know Akkaraju over the months as well as saw how Exo’s technology was improving.

“We are seeing an expanding opportunity in healthcare technology as it improves and costs go down,” he added. “The vision Sandeep has of democratizing the ultrasound is not a vision that was possible 15 or 20 years ago. We are seeing the market in its early stage, but we also recognize the potential. Every doctor should want one to see what they were not able to see before. As technology and biology improves, we are going to see this sector grow.”

 

UK’s Mindtech raises $3.25M from In-Q-Tel, among others, to train CCTV cameras on synthetic humans

By Mike Butcher

Imagine a world where no one’s privacy is breached, no faces are scanned into a gargantuan database, and no privacy laws are broken. This is a world that is fast approaching. Could companies simply dump the need for real-world CCTV footage, and switch to synthetic humans, acting out potential scenarios a million times over? That’s the tantalizing prospect of a new UK startup that has attracted funding from an influential set of investors.

UK-based Mindtech Global has developed what it describes as an end-to-end synthetic data creation platform. In plain English, its system can imagine visual scenarios such as someone’s behavior inside a store, or crossing the street. This data is then used to train AI-based computer vision systems for customers such as big retailers, warehouse operators, healthcare, transportation systems and robotics. It literally trains a ‘synthetic’ CCTV camera inside a synthetic world.

It’s now closed a $3.25 million early-stage funding round led by UK regional backer NPIF – Mercia Equity Finance, with Deeptech Labs and In-Q-Tel.

That last investor is significant. In-Q-Tel invests in startups that support US intelligence capabilities and is based in Arlington, Virginia…

Mindtech’s Chameleon platform is designed to help computers understand and predict human interactions. As we all know, current approaches to training AI vision systems require companies to source data such as CCTV footage. The process is fraught with privacy issues, costly, and time-consuming. Mindtech says Chameleon solves that problem, as its customers quickly “build unlimited scenes and scenarios using photo-realistic smart 3D models”.

An added bonus is that these synthetic humans can be used to train AI vision systems to weed out human failings around diversity and bias.

Mindtech CEO Steve Harris

Mindtech CEO Steve Harris

Steve Harris, CEO, Mindtech said: “Machine learning teams can spend up to 80% of their time sourcing, cleaning, and organizing training data. Our Chameleon platform solves the AI training challenge, freeing the industry to focus on higher-value tasks like AI network innovation. This round will enable us to accelerate our growth, enabling a new generation of AI solutions that better understand the way humans interact with each other and the world around them.”

So what can you do with it? Consider the following: A kid slips from its parent’s hand at the mall. The synthetic CCTV running inside Mindtech’s scenario is trained thousands of times over how to spot it in real-time and alert staff. Another: a delivery robot meets kids playing in a street and works out how to how to avoid them. Finally: a passenger on the platform is behaving erratically too close to the rails – the CCTV is trained to automatically spot them and send help.

Nat Puffer, Managing Director (London), In-Q-Tel commented: “Mindtech impressed us with the maturity of their Chameleon platform and their commercial traction with global customers. We’re excited by the many applications this platform has across diverse markets and its ability to remove a significant roadblock in the development of smarter, more intuitive AI systems.”

Miles Kirby, CEO, Deeptech Labs said: “As a catalyst for deeptech success, our investment, and accelerator program supports ambitious teams with novel solutions and the appetite to build world-changing companies. Mindtech’s highly-experienced team are on a mission to disrupt the way AI systems are trained, and we’re delighted to support their journey.”

There is of course potential for darker applications, such a spotting petty theft inside supermarkets, or perhaps ‘optimising’ hard-pressed warehouse workers in some dystopian fashion. However, in theory, Mindtech’s customers can use this platform to rid themselves of the biases of middle-managers, and better serve customers.

Sweetch raises $20M for a personalized engagement system designed to boost health outcomes

By Emma Betuel

You’ve just sat down to dinner, and your wearable device reminds you to get up and get in your steps for the day. Maybe the app has a point, but odds are, you’ll push the notification to the side. The founders of Sweetch, an Israeli company creating its own AI-driven behavior change app, are betting that if you got that notification in a different way, you’ll be more likely to take its advice. 

Yossi Bahagon, the founder of Sweetch, describes the company’s approach to digital reminders as a mixture of artificial intelligence and emotional intelligence. The app will use AI to analyse “lifeprint” data picked up through a smartphone. Then it delivers messages to when you might be more likely to respond to them and in a “tone of voice” that encourages compliance. 

For instance if you have meetings on Mondays between 12 and 3, but still want to get in some exercise, Sweetch won’t suggest getting a workout in during those times, or shame you for sitting through a meeting rather than getting a run in. 

“It’s about ongoing hyper-personalized engagement that increases the likelihood of the patient doing what he or she needs to do,” says Bahagon. 

On Monday, Sweetch announced a $20 million Series A round led by Entreé Capital. Other investors include Noaber, Kortex Ventures, Insurtech VC, Fin TLV Ventures, and existing investors Philips, OurCrowd, and Qure Ventures. 

Bahagon is a family physician by training, but he’s spent the majority of his career in the digital health arena. In 2008 Bagahon founded the digital health division of Clalit Health Services, a non-profit insurance and medical services provider that currently insures 60 percent of the Israeli population. His previous company, Luminox Health, was acquired by Israeli investor platform OurCrowd in 2016, and Bahagon stayed on to manage the fund’s digital health arm. 

Sweetch, which was founded in 2013, is yet another digital health venture for Bahagon –  this time aimed at increased patient compliance. The app has already generated some interest, and was one of five apps selected from over 400 to participate in the Bayer G4A program, something like an accelerator developed by the pharmaceutical giant. 

So far, Sweetch CEO Yoni Nevo says the app has “tens of thousands of users,” (the company would not provide a specific number).

It’s currently being used in patients with cardiovascular diseases, diabetes, obesity, hypertension, rheumatoid arthritis, inflammatory bowel disease, and, in a bit of a departure from the rest: breast cancer treatment. 

Sweetch isn’t designed for users to download at will on the app store (you can download it, but won’t get far without an access code); their go-to market strategy is instead to partner with healthcare organizations, pharma companies, payers or providers. Then providers might prescribe Sweetch alongside the actual treatment to encourage them to stick with it.

There is evidence that people don’t always follow doctors’ orders – particularly when it comes to chronic conditions. One 2017 report from the CDC notes that one in five prescriptions written in the United States are never filled, and up to 50 percent of medicines were taken incorrectly (at the wrong time, wrong dose, etc). 

Improving patient compliance, though, is a more complicated problem. The CDC report outlined a few solutions – some of which have more to do with the healthcare system than they do with health tech. Those include lowering economic barriers to medication, increasing team-based healthcare (your pharmacist and doctor coordinating prescription refills, for instance), and increasing access to healthcare in the first place. 

The report does highlight an avenue for health information technology to help address the non-compliance problem (it specifically mentions e-prescribing software). 

Tech, like Sweetch, can only address the non-compliance problem in medicine if it doesn’t have a non-compliance problem of its own. To that end, Bahagon says the app has a record of user retention. “Even after 24 months, we still see around 45% of the patients that started using the system continue to use it,” he says.  

User retention is a good sign for any app developer. But in the health space, it’s more complicated. Some studies suggest that consumer ratings are poor markers of how well these apps work to improve outcomes (you might like an app and use it, but it doesn’t make you any healthier). 

In that regard, Sweetch does have a trial under its belt, conducted at two sites in the Johns Hopkins Clinical Research Network. 

The app was tested on 55 adults with prediabetes over the course of three months. Forty-seven of the participants finished the trial, and on average, they increased their physical activity by an average of 2.8 MET-hours (they may have actually exercised for shorter periods, but their intensity was the equivalent of 2.8 hours of work), and lost about 1.6 kilograms. 

The users also lowered their A1c levels, a key measure of average blood sugar. Prediabetic adults usually have an A1c between 5.7 and 6.5 percent, and those in this trial reduced their A1c levels by about .1 percent (the study refers to that reduction as “clinically meaningful.”) 

This study didn’t specifically compare Sweetch to any other prediabetes interventions. However, a study on that is upcoming. In a December 2020 interview, Bahagon noted that Sweetch had received a grant from the National Institutes of Health to continue testing Sweetch against other “gold standard” interventions for diabetes. 

Nevo and Bahagon didn’t provide concrete updates on the project, but noted that “in a month or so” the company may announce updates on the NIH funding and upcoming randomized controlled trials. 

In the meantime, the company plans to use the Series A funding to expand into markets in the US and Brazil, grow the user base, and enhance the platform to provide specific and tailored recommendations for even more conditions. 

US blames China for Exchange server hacks and ransomware attacks

By Zack Whittaker

The Biden administration has formally accused China of the mass-hacking of Microsoft Exchange servers earlier this year, which prompted the FBI to intervene as concerns rose that the hacks could lead to widespread destruction.

The mass-hacking campaign targeted Microsoft Exchange email servers with four previously undiscovered vulnerabilities that allowed the hackers — which Microsoft already attributed to a China-backed group of hackers called Hafnium — to steal email mailboxes and address books from tens of thousands of organizations around the United States.

Microsoft released patches to fix the vulnerabilities, but the patches did not remove any backdoor code left behind by the hackers that might be used again for easy access to a hacked server. That prompted the FBI to secure a first-of-its-kind court order to effectively hack into the remaining hundreds of U.S.-based Exchange servers to remove the backdoor code. Computer incident response teams in countries around the world responded similarly by trying to notify organizations in their countries that were also affected by the attack.

In a statement out Monday, the Biden administration said the attack, launched by hackers backed by China’s Ministry of State Security, resulted in “significant remediation costs for its mostly private sector victims.”

“We have raised our concerns about both this incident and the [People’s Republic of China’s] broader malicious cyber activity with senior PRC Government officials, making clear that the PRC’s actions threaten security, confidence, and stability in cyberspace,” the statement read.

The National Security Agency also released details of the attacks to help network defenders identify potential routes of compromise. The Chinese government has repeatedly denied claims of state-backed or sponsored hacking.

The Biden administration also blamed China’s Ministry of State Security for contracting with criminal hackers to conduct unsanctioned operations, like ransomware attacks, “for their own personal profit.” The government said it was aware that China-backed hackers have demanded millions of dollars in ransom demands against hacked companies. Last year, the Justice Department charged two Chinese spies for their role in a global hacking campaign that saw prosecutors accuse the hackers of operating for personal gain.

Although the U.S. has publicly engaged the Kremlin to try to stop giving ransomware gangs safe harbor from operating from within Russia’s borders, the U.S. has not previously accused Beijing of launching or being involved with ransomware attacks.

“The PRC’s unwillingness to address criminal activity by contract hackers harms governments, businesses, and critical infrastructure operators through billions of dollars in lost intellectual property, proprietary information, ransom payments, and mitigation efforts,” said Monday’s statement.

The statement also said that the China-backed hackers engaged in extortion and cryptojacking, a way of forcing a computer to run code that uses its computing resources to mine cryptocurrency, for financial gain.

The Justice Department also announced fresh charges against four China-backed hackers working for the Ministry of State Security, which U.S. prosecutors said were engaged in efforts to steal intellectual property and infectious disease research into Ebola, HIV and AIDS, and MERS against victims based in the U.S., Norway, Switzerland and the United Kingdom by using a front company to hide their operations.

“The breadth and duration of China’s hacking campaigns, including these efforts targeting a dozen countries across sectors ranging from healthcare and biomedical research to aviation and defense, remind us that no country or industry is safe. Today’s international condemnation shows that the world wants fair rules, where countries invest in innovation, not theft,” said deputy attorney general Lisa Monaco.

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