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Main article: Health

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Canadian online pharmacy, PocketPills has raised $7.35 million as it expands into Quebec

04:16 | 20 February

PocketPills, which bills itself as the sole online pharmacy operating in Canada, has raised $7.35 million in new financing as it expands across the country.

Through partnerships with insurers like Pacific Blue Cross the company provides co-insurance reductions for prescriptions. “We have an option for you to come and join our platform just like any pharmacy,” says company co-founder and chief operating officer, Harj Samra.

Samra launched the company in 2018 with Raj Gulia, a fellow proprietor of pharmacies across Canada, and the serial entrepreneur and co-founder of RocketFuel Abhinav Gupta. After RocketFuel’s public offering, Gupta was toying with several ideas for direct to consumer companies when he was approached by Gulia and Samra.

Together the three men launched PocketPills to bring the online pharmacy model to Canada as a way to save money for insurers.

The problem for insurers is that the use of generic drugs in Canada lags behind that of the U.S., says Gupta. “The difference is quite substantial. The U.S is about 90% generic fill rate and in Canada that number is at 70%,” he says. 

PocketPills covers everything that a regular Canadian pharmacy would outside of controlled substances and narcotics. The bulk of the company’s prescriptions to date are for medications for chronic conditions.

Now the company is looking to expand across the country, opening fulfillment locations in Nova Scotia and soon in Quebec.

To back that growth and continue its development, PocketPills turned to a large Canadian family office and the investment firm Waterbridge to finance its $7.35 million round.  

“PocketPills is timed well for massive value creation in the Canadian health care industry through its technology innovations. It has captured a sweet spot at the intersection of cost (insurers and employers), convenience (patients) and care (chronic diseases),” said Manish Kheterpal, Managing Partner, WaterBridge Ventures, in a statement.

 

 


0

Secret’s founder returns with anti-loneliness app Ikaria

21:31 | 18 February

“I don’t feel good about that. That sucks” Chrys Bader-Wechseler reflects when asked about the bullying that went down on the anonymous app Secret he co-founded in 2013. After $35 million raised, 15 million users, and a spectacular flame out two years later, the startup was dead. “Since I left secret I feel alive and aligned with my values and my purpose again.” 

But there was one bright side to Secret letting you post without a name or consequences. People opened up, got vulnerable, and felt less alone when comments revealed they weren’t the only person dealing with a certain struggle. What Bader learned from watching Secret’s users “do this in the dark” was the realization that “actually, we need to learn to do this in a light, to have that same kind of dialogue, but do it openly with each other.”

So began the journey to Bader’s new startup Just Imagine that’s exclusively revealing itself to the world today on TechCrunch. It’s building a different kind of chat app called Ikaria, named after the Greek island where close-knit community helps extend people’s lifespans. The 6-person Santa Monica team is funded by a $1.5 million seed round led by Initialized Capital. People can sign up for early beta access here.

During a long interview about the startup, Bader and his co-founder Sean Dadashi were cagey about exactly how Ikaria works since it’s still in development. Amidst all the philosophical context about the app’s intention, I was able to pull out a few details about what the product will actually look like.

“Basically, since 2004, technology has created this monumental shift in the human social experience. We’re more connected than ever technically but all the studies show we’re lonelier than ever.” Bader explains. “It’s like eating McDonald’s to get healthy. It’s not the right source of nutrition for our social well-being because true connection requires a level of vulnerability, presence, self-disclosure, and reciprocity that you don’t really get on these platforms.”

Ikaria isn’t another feed. It’s a safe space where you can chat with close friends & family, or people going through similar life challenges. Members of these group chats will optionally go through guided experiences that help them reflect on and discuss what’s going on in their hearts and minds. This could become a whole new media format where outside creators or mental health professionals could produce and contribute their own guided experiences.

“Part of the reason we’re announcing this is that . . . it’s a call to action to involve all these practitioners and people who are doing these types of things and giving them a platform to allow them to facilitate these kind of group bonding experiences through a platform where they can extend their practices into the digital world” Bader tells me. What Calm and Headspace did for making meditation more mainstream and accessible, Ikaria wants to do for mental health through online togetherness.

Ikaria already has a sizable closed beta going which the startup plans to continue until it finds product fit, and it hopes to know its official release timeline by the end of the year. “We’re not going to launch this until we know 40% of people would be disappointed if they couldn’t use it.”

Rather than monetizing by exploiting people’s attention, Ikaria plans to develop a ‘customer relationship’ with users, which could mean subscription access or in-app payments for buying content. Perhaps one user could act as the sponsor and purchase an experience for their whole group chat. Until then, it’s got its seed funding from Initialized, Fuel Capital, F7 Ventures, Ryan Hoover’s Weekend Fund, Backend Capital, Day One Ventures, Shrug, Todd Goldberg, and Superhuman’s Rahul Vohra.

“The hope is that eventually this would be an app you use instead of iMessage, to increase your sense of presence” Bader explains, revealing its grand ambitions. Why would we need to replace our core chat apps? Well for one thing, they don’t understand who really matters to you. If an app understood who your mom is, it could give her messages special prevalence or remind you to contact her.

Bader met Dadashi through an offline men’s group for discussing life, love, and everything. After just a few weeks of these meetups, they say they felt closer to each other than to most of their friends. Only later did Bader, a designer by trade, discover that Dadashi was a coder who’d been CTO of electronics company MHD Enterprises before starting a travel and lifestyle startup for mental wellness called Somatic Studios.

Together, they researched the rapid rise of other vulnerability-focused meetup organizations like EvrymanManKind ProjectQuiltAuthentic RelatingCircling, and T-Groups. But they knew that to have a chance at impact at scale, they’d need to build a mobile app familiar enough to get people over the hurdle of starting a mindfulness practice. They laid out a few principles to build by: a focus on relationships instead of Likes and followers, conscious design that won’t exploit people’s attention or weaknesses, no ads, and keeping all data private and in control of the user.

Having known Bader since the Secret days, it’s obvious that working with Dadashi has made him happier and more centered. Ikaria is an app he can wake up feeling good about each day. “You know, I don’t like to speak ill of David [Byttow, Secret’s CEO who was notoriously prickly], but that relationship was very, very toxic and taxing for me. And this time around with Sean, as I’m sure you can tell, is the polar opposite.”

If Ikaria can help people develop the open and honest relationships with friends or peers like building it has done for Bader and Dadashi, it could be a beacon amidst a sea of time unwell spent.

 


0

Tinder founder funds sex tips app Lover

23:26 | 14 February

Want to spice up the bedroom without paying for pills or awkward visits to a sex therapist? A new app called Lover lets you take a sexual personality quiz, explore carnal knowledge tutorials, and discretely figure out which turn-ons you share with your partner. Built by board certified sexual medicine clinical psychologist Dr. Britney Blair, Lover launches today on iOS with $5 million in seed funding from Tinder founder Sean Rad and other investors.

“It is strange that there are such taboos around sex when it is something we all do…whether we enjoy ourselves or not. We think it is time to start the conversation around this important aspect of our health” says Dr. Blair. “We believe Lover can help build confidence, facilitate communication, improve partner connection and just raise consciousness about sex and sexuality.”

A solid portion of Lover’s content is free for the first seven days, including audio guides to oral sex, video explainers on how to be generous in bed, and multi-step “playlists” of content like “Getting Hard, Made Easy”. Lover charges $9.99 to keep using it to dive deeper into themed educational materials like “Coreplay Not Foreplay” and “Fantasy To Reality” that are recommended based on the result of your sexual style questionnaire.

Almost 50% of women and 40% of men have a sexual complaint . . . [but] most people don’t realize how common and treatable their issues are” Dr. Blair tells me. “In our [pre-launch tests] focused purely on erectile dysfunction, 62% of users reported improvements to their erections within three weeks of using the app. That’s pretty wild when you think Viagra’s efficacy rate is approximately 65% and it lasts only five hours.”

With startups like digital pharmacy Ro scoring a $500 million valuation just 18 months after launching by prescribing and selling men’s health drugs like viagra, Lover sees a market for education-based alternative approaches to sexual wellness.

Lover co-founders (from left): Jas Bagniewski, Dr. Britney Blair, and Nick Pendle

Dr. Blair got interested in the space a decade ago after a Stanford grad school lecture illuminated how prevalent sexual problems are but how quickly they can be resolved with learning and communication. She teamed up with her CEO Jas Bagniewski who’d been the manager of Europe’s largest ecommerce business Zalando in the UK, and a founder of City Deal that sold to Groupon. Bagniewski and fellow Lover co-founder Nick Pendle started European Casper mattress competitor Eve Sleep and brought it to IPO.

The plan is to combine Dr. Blair’s educational materials with Bagniewski and Pendle’s ecommerce chops to monetize Lover through subscriptions and eventually recommending products like sex toys for purchase. Now they have $5 million in seed funding led by Lerer Hippeau, and joined by Manta Ray Ventures, Oliver Samwer’s Global Founders Capital, Fabrice Grinda, and Jose Marin. The cash will go towards building out an Android app and adding games that partners can play together in bed.

There are plenty of random sex tip websites out there. Lover tries to differentiate itself by personalizing content based on the results of a Myers-Briggs-esque quiz that asks you how adventurous, communicative, and assertive you are. You then receive a classification like “The Muse” with a few pages of explanation, for example revealing how you like to inspire others while being the center of attention.

From there, Lover can suggest guides for mastering your own sexual personality or branching out into new behavior patterns. There’s also a feature copied from another app called XConfessions for figuring out what you and your partner like. You connect your apps and then separately swipe yes or no on questions about whether you’d like “having your partner drip candle wax on you” or “your partner dressing as a strict cop”. If you and they match, the app tells you both so you can try it out.

Overall, Lover’s content is a lot higher quality and more compassionate than where most people learn about sex: from pornography. Having a real sexual medicine doctor overseeing the app lends credibility to Lover. And the design and tone throughout make you feel empowered rather than sleazy.

Still, Dr. Blair admits that “it’s hard to motivate people into behavioral change, people already have subscription apps on their phones and we may run into ‘subscription fatigue'”. People might feel natural paying for viagra because the impact is obvious, the value of a subscription to sex tips might feel too vague or redundant to what’s free online.

To get a lot of users opening their wallets, not just their pants, Lover will need to do a better job of previewing what’s behind the paywall, and offering more interactivity that online content lacks. But if it can give users one unforgettable night thanks to its advice, it may be able to seduce them for the long-run.

 


0

This co-op wants to put money back into patients’ hands

18:28 | 14 February

Too often, people are asked to give away their insights and time for free. Jen Horonjeff, founder and CEO of healthcare startup Savvy, knows this first hand and is trying to change that by applying a cooperative model to her business.

As an infant, Horonjeff was diagnosed with juvenile idiopathic arthritis. Since then, she has been diagnosed with a number of autoimmune conditions. Seven years ago this month, she had a brain tumor removed.

“I’ve just always been somebody who’s been a patient,” Horonjeff tells TechCrunch.

Horonjeff’s experience in the health system led her to become a human factors engineer focused on human-centered design, she says. In that area, work centers on trying to fit the world to people with different abilities, rather than the other way around. From there, Horonjeff, who has her doctorate in environmental medicine, has been most interested in patient-centered outcomes.

“So what matters to patients and what affects their health and health behaviors outside of just the traditional things [are what] we’ve been looking at,” she says. “It was being on that side of the professional equation that I heard my colleagues and partners talking about wanting to help patients, but they were never talking with them. And what they were talking about were not the same priorities as the patient communities that I was part of. And because I’m very open about my condition, they kept coming to me to ask me to be that sole patient representative. When they kept coming back to me, that was really a signal of a diversity issue, since I am white with a Ph.D. in New York City.”

Horonjeff’s discomfort with the lack of diversity led her to become a matchmaker between healthcare innovators and patient communities. This is where the idea for Savvy was born.

 


0

Innovaccer wants to be the service that unifies all healthcare data

05:30 | 14 February

The holy grail for technology companies working in the healthcare industry is becoming the gateway for all healthcare data.

Big legacy providers like Epic and Cerner are trying to reach out to hospital networks to hoover up all of their data. Google is interested in it. Salesforce is interested in it. Everyone wants to be the resource that organizes and manages healthcare data for physicians and hospital providers — everyone including the San Francisco-based startup Innovaccer, which has raised $70 million in new financing to finance its mission.

The new investment from firms including Steadview Capital, Tiger Global, Dragoneer, Westbridge Capital, the Abu Dhabi investment firm Mubadala Capital, and Microsoft’s corporate investment arm, M12.

These are deep-pocketed investors for whom money is no object, but Innovaccer has shown a fair bit of traction among hospitals and health systems with its data analysis and management platform.

The company’s software pulls from datasets including those generated by Cerner and Epic’s healthcare records, as well as insurance companies and pharmacies to create a more holistic view of a patient, the company says.

Since its launch in 2014, Innovaccer has provided a single source or healthcare information for 3.8 million patients and saved healthcare systems more than $400 million, the company said.

“Healthcare still needs a lot of work to become patient-centered and connected by organizing information and making it more accessible. It is really important to make patient data seamlessly available to all providers along the patient’s care journey,” said Abhinav Shashank, the co-founder and chief executive at Innovaccer, in a statement. “We have been fortunate to work with transformational healthcare initiatives that our amazing customers are engaged in. The vision of helping healthcare work as one needs a connected and open technology framework. We are excited to be at the forefront of providing the tech platform for our customers to drive that change.”

Its technology relies on over 200 APIs to take data from health plans, primary care providers, pharmacies, labs and hospitals and serves that data to 25,000 care providers. The company hopes to take that number ot over 100 million healthcare records and 500,000 caregivers over the next several years.

It’s a lofty goal, but one that appeals to the Ravi Mehta, the founder of the $2.5 billion hedge fund Steadview Capital.

“By using their connected care framework coupled with their leading-edge data aggregation and analytics platform, they are unifying patient records and enabling care teams to coordinate patient care at a new level,” said Mehta. “We believe this will achieve greater efficiencies, enable better care and reduce overall healthcare spend in the years to come.” 

 


0

ePharmacy Ro launches doc-approved WebMD rival Health Guide

19:58 | 12 February

‘Whatever your symptom, WebMD says you have cancer.’ It’s a long-running joke that underscores the distrust of perhaps the top source of medical advice, stemming from a confusing site clogged with ads that’s been criticized for questionable information and pushing pills from its sponsors.

Health Guide is the new medical handbook for the internet where 30% of content is written by doctors and 100% is reviewed by them. On a single clean, coherent page for each condition, it lays out a tl;dr summary, what the ailment really is, how to spot the symptoms, and what you need for treatment. Rather the pushing you to nervously keep clicking, it just wants to answer the question.

Health Guide officially launches today. It was built by digital pharmacy Ro, that’s raised $176 million for medicine brands Ro for men’s health, Rory for women’s health, and Zero for smoking cessation. With Ro, patients can get a $15 telemedicine consultation with a doctor, receive an instant prescription, and have it filled and sent to you from the startup’s in-house pharmacy operating in all 50 states. A competitor to Hims & Hers, Ro scored a $500 million valuation last year.

Rather than aggressively hawking its own products at the end of articles, Health Guide just lists the medications you could take, insists you ask a doctor what’s right, and leaves it up to you to choose where to buy.  Ro founder Zachariah Reitano calls Health Guide “A significant investment in trust. There’s not a clear ROI (return on investment) to it but it’s one of those long-term bets . . . Providing education to patients will serve Ro really well in the long-run.” He acknowledges the suspicions of self-dealing, and says “if we don’t do this correctly, it can hurt more than it can help.”

On Health Guide you can search for specific conditions, browse categories like diabetes or hair loss, and browse featured articles like ‘Proven ways to increase the density of your bones’ or ‘How do you test for gonorrhea’. There are no banner ads, so your search about the flu or testosterone won’t immediately lead to you being bombarded with promotions for Mucinex or dicey supplements. “On these other sites . . you have [advertisers] with unregulated supplements and services that are the highest bidder beside medical information, which creates a lot of distrust.”

The simplicity and accuracy of Health Guide has already attracted a sizable audience. It’s on pace to reach 30 million readers this year, with 25% being women despite Ro’s initial focus on aiding men with erectile dysfunction. It already ranks in the top 10 Google results for 300 medical questions. The no-filler entries come signed by the specific doctors that wrote or approved them, and Ro pledges to have them reviewed and updated at least once per year. At the bottom are links to all the original source material, including peer-reviewed medical journals.

Reitano tells me that the idea from Health Guide came after Ro’s physicians and customer service were bombarded with the same patient questions over and over. The easiest move was to put all the answers on an open site they could send patients to. A major goal was debunk hoaxes other sites often don’t address directly. “For something like vaccines where there is a potential for misinformation, you’ll see us take a strong stance. We won’t let the potential for misinformation spread through Health Guide.”

One thing Health Guide is missing that could keep people coming back to WebMD is a symptom checker. Right now it’s better at research on major conditions or lifestyle choices than figuring out why your throat’s sore. But given it’s day one and Ro has tons of funding, it has plenty of time to improve. There’s sure to be concerns about how it collects data and what treatments Health Guide lists. So as a precaution, it never forcefully makes recommendations besides asking a doctor for personalized advice, and there’s just one button atop the site for visiting its medication marketplace.

Ro is trying to move fast as the ePharmacy space heats up. It plans to launch 10 more products in the next two quarters, with a focus on Rory for women. It just struck an exclusive deal with Pfizer to provide Roman customers with generic viagra, offering clear supply chain transparency around a drug that’s often counterfeited. And thanks to its licenses across all states, it’s helping new weight loss treatment Plenity launch nationwide atop its diagnosis, prescription, and fulfillment technology.

Yet Reitano sees space for multiple startups to succeed in replacing embarrassing and inconvenient in-person trips to the doctor or drug store. “It might be a somewhat cheesy answer but . . . the best thing about competition is it makes everyone build a better experience for patients” he says, citing NURX and PillClub enhancing birth control access. “I think all this innovation in digital health — it’s an absolutely massive market. No one’s taking market share from someone else. We’re raising the bar for care.”

 


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A list of MWC coronavirus cancellations so far

12:56 | 11 February

The world’s biggest mobile tradeshow, Mobile World Congress (MWC), is due to take place in Barcelona just under two weeks’ time, on February 24-27.

The annual international telco industry event typically attracts more than 100,000 delegates from around 200 countries across the conference’s four days — with every major telco and tech giant exhibiting (with the exception of Apple which prefers its own events).

But with international concern now focused on the novel coronavirus outbreak, which was declared a global emergency by the World Health Organization late last month, a growing number of companies have announced they are pulling out of attending. Others, such as Telenor, TCL and ZTE, have cancelled press events or said they will scale back their presence though are still planning to attend.

MWC’s organizer, the GSMA, has announced a series of restrictions intended to reduce the risk of the coronavirus infections at the conference, including a ban on travellers coming from the province in China where the virus was first identified. It has also said it will implement temperature screening of attendees; require conference-goers self-certify they have not come into contact with an infected person; and is suggesting delegates adopt a ‘no hand shake’ policy in a bid to limit contact.

See below for a list of companies that have cancelled their attendance at the conference — we’ll update with any additions as we get them

Companies that have cancelled their attendance at MWC 2020

Accedian

Amazon

Amdocs

CommScope

Ericsson

Intel

LG

Nvidia

NTT Docomo

Sony

 


0

CurieMD is using telehealth to plug the menopause support gap

00:22 | 11 February

U.S. femtech startup CurieMD is offering menopause diagnosis and treatment prescription via a telehealth platform — beginning in California, where it launched late last year.

Founder Dr Leslie Meserve says the goal is to widen access to treatment and support services for mid-life women, spying a business opportunity in offering an auxiliary digital service targeting an area of women’s health which she says is often overlooked within standard health service provision and suffers from a lack of trained physicians.

She also suggests there is a “unique fear” in the U.S. around the use of hormone therapy for treating the menopause that’s left an access gap in support services — blaming concerns sparked by misleading publicity attached to the 2003 Women’s Health Initiative study which implied a link with breast cancer.

“The authors of the study released a press release prematurely that then became an overnight sensationalized story about hormone therapy causing breast cancer,” she explains. “What they didn’t say was that in the estrogen-only arm of the trial there was actually a lower incidence of breast cancer. So that was never stated anywhere. The other thing they failed to state was that the slight increased risk was not statistically significant… They did women a huge disservice by releasing this press release prematurely.”

More than fifteen years on, Meserve believes the time is right for telehealth services to help plug the information and support gap that still orbits the menopause, in part as a consequence of “deeply rooted” but misplaced fear of hormone therapy.

Investment in products targeted women’s health and wellness has also been jumping up in recent years as VCs cotton on to an underinvested opportunity which more founders are also focusing on — led by female entrepreneurs driving attention toward women’s issues.

There are now a number of femtech startups specifically focused on the menopause. Asked about competitors Meserve points to several other U.S. startups — including Gennev and Elektra Health.

“There is a lot more interest in telehealth and I believe the time is absolutely right for more information to be given to the world… to make sure that women know that going through menopause is not the end of anything — it’s the beginning of a wonderful second half of life,” she suggests, arguing that the regular healthcare services women are accessing often don’t have the time to dedicate to discussing menopausal symptoms and potential treatments with their patients.

“Telehealth is not going to be appropriate for every single medical issue that’s for sure of but the diagnosis and treatment of menopausal symptoms is really based on a discussion,” she says. “We do let patients know that we are an adjunct to the regular care that they need to be receiving from their gynecologist and primary care physicians. But menopausal treatment requires a lot of discussion, a lot of talk therapy — it’s a very cognitive diagnosis and treatment. And many OB-GYNs and primary care doctors really don’t have the time needed to explain the pros and cons of hormone therapy to their patients.

“They do the physical. They address immediate, urgent needs but they may not have the time to address something that doesn’t feel as urgent. Menopausal symptoms — from insomnia to hot flushes — they don’t feel as urgent to practitioners so I don’t think that they’re always given the time needed. And we know that physicians and other practitioners are very rushed. The way our insurance models go they have to see patients every nine to 15 minutes and sometimes a 15 minute office visit just isn’t enough to perform both a pap smear, a physical and answer all of these questions. So we’re an adjunct. We’re not in place of their regular physical exams — we’re an addition to those.”

Meserve practiced in primary care for close to two decades before moving into specializing in menopause services herself — a shift that led to the idea of setting up a company to address mid-life women’s health issues via a web-based telehealth platform.

“I’ve kind of grown up with my patients and a few years ago I was noticing that my patients were having lots of menopausal symptoms so I self-trained in the treatment of menopause and then became a certified menopause practitioner,” she tells TechCrunch, explaining her own transition from practicing in primary care to focusing on menopause care. 

“I realized obviously I was only going to be able to see a very small number of patients and patients in my community. And I know that women across the country are suffering with these symptoms and they’re not able to find physicians that are comfortable talking about menopause and treating menopause. And so, through friends of friends, I was connected to another physician in our community, along with his friend who has expertise in startups and we had the idea [for the company].”

“We know that there’s a lack of trained physicians in this area, we know that women want this relief — they want symptom relief, they want to live wonderful lives,” she adds, saying the key idea is to use telehealth consultations and algorithmic triage to reach “as many women as are wanting the treatment”.

CurieMD patients fill in an online quiz about themselves and their symptoms to get treatment suggestions — which can include a prescription for an oral contraceptive or, in cases where there may be a risk associated with taking estrogen, an antidepressant for perimenopausal symptom relief; and a plant-based hormone therapy for menopausal women — with the startup using an algorithm to help the telehealth practitioners offer the right treatment suggestions.

“Based on the way that patients answer questions in our questionnaire they’re driven down a certain path to help our practitioners choose the right therapy,” she explains, noting that they’re not using AI to drive recommendations. Rather patients’ responses are used to determine which additional questions they get asked to get pull out other relevant information — in a classic decision tree algorithm.

“The first thing we have to determine is whether they’re in perimenopause or menopause,” she says, discussing the decision flow. “So in perimenopause their cycles are fluctuating, their ovaries are coming in and out of retirement. That happens in their 40s. And women start to have perimenopausal and menopausal symptoms at that time — many of them do. So they”ll be having hot flushes, night sweats, irritability, mood symptoms. But the treatment for perimenopause is different from menopause. Perimenopausal patients can be treated very effectively with low dose oral contraceptive pills — so one of the algorithm’s branches is, first of all, are you in menopause or perimenopause?

“And then for menopausal patients they have the option of choosing bioidentical hormone therapy. And if they have had a hysterectomy they only need estrogen — and so they would go down the pathway asking about their estrogen needs. And then if they still have a uterus they will need both estrogen and progesterone. So then they have the choice of what type of estrogen they want to choose — whether they want oral estrogen or estrogen delivered through the skin, which is a patch.”

In cases where a woman is having vasomotor symptoms such as insomnia and hot flushes but has had breast cancer or where there’s another contra-indication to estrogen (such as having previously had a blood clot) CurieMD’s platform may prescribe an antidepressant to treat her symptoms.

“They are candidates for an antidepressant called Venlafaxine [that’s] very effective for treating vasomotor symptoms in all patients — but we use it mostly for women who are unable to take estrogen,” says Meserve.

For now the platform has just three doctors performing remote consultations for the “dozens” of early sign ups it’s seen so far — with a third party company supplying the trained physicians that are conducting the remote consultations.

“We’re working with a large, national company that hires physicians who have chosen to provide telehealth,” she says. “They’re board certified and we provide additional training in women’s health for them — especially in the medications… that we offer.”

Per Meserve CurieMD applies “narrower” prescribing guidelines than an in-person physician might use — exactly “because it is a telehealth company”.

She gives the example of a patient who has had a blood clot in the past — where an in-person physician might be able to discuss with a patient’s haematologist and come up with a plan for them to be on a very low dose estrogen patch. In this case CurieMD’s remote service would not be able to offer such a joined-up approach to prescribing a treatment.

“In telehealth we don’t know all the physicians in each patient’s community so we’re not going to be able to do co-ordinated care as well with specialist, outside of the box patients,” she says. “So if they have any risk factors, such as a history of clotting, or of course if they have a history of breast cancer we’re not going to be able to treat those patients with hormone therapy. So if they really want hormone therapy that’s going to be an in-person visit with a physician.”

Another exception would be patients who have migraines and who may want to be on an oral birth control pill. “It depends on the type of migraines they have,” she says. “So that’s beyond the scope of what we’re going to prescribe.”

As part of the questionnaire process patients are also asked to rate the severity of their symptoms. Meserve says she’s confident this will enable it to not only demonstrate to individual patients the efficacy of the prescribed treatment but also enable it to present findings to the wider medical community — with the aim of demonstrating “the safety and efficacy of telehealth” for this particular use-case.

“One of the things that I’d like to make sure that we’re doing is really convincing the medical community at large about the safety of telehealth in certain medical conditions,” she says. “It’s not appropriate for every medical condition… There are certain things that need to have an in person visit. But the medical community is starting to understand and adapt and trust telehealth — but I think the more data that we have the more we’re going to be able to convince them that this is a nice adjunct to in person visits.”

“Patients are more accepting of [telehealth] than physicians are. Physicians are very conservative and very slow to change and so I feel that one of our missions is to present the data to physicians and help them understand that this is not a substitute for good in-person care, it’s just an addition,” she adds.

The business model for the service is direct to patient — which means CurieMD is not plugging into the US insurance healthcare market. Rather there’s a sign up fee (currently waived), a per consultation fee and recurring subscription (taken via credit card) for any ongoing prescriptions which are shipped to patients by a mail-order pharmacy contracted for that piece of the service. (In an FAQ on its website startup claims its consultation fees “are lower than that of most copays and our medication pricing is competitive with that of most pharmacies”.)

The team has raised around $1M in angel and VC investment to fund development of the business so far.

Meserve says the plan is to scale nationwide, taking a state by state approach to building out coverage in order to get the necessary contracts and physician licences in place.

“I would like to be in another 20 states by the end of this year,” she adds.

In terms of differentiation vs the growing number of femtech startups that have also supported an opportunity to offer menopause-related treatment support she says: “We believe we’re the only one that contracts with a pharmacy and has the prescription delivered through a mail order service.”

She also flags that the hormone therapy CurieMD’s service prescribes — and delivers “right to the door in discreet packaging” — is a bioidentical plant-based “FDA-approved” treatment, suggesting that’s another point of differentiation for its approach.

 


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Tangerine’s pretty self-care app combines habit and mood tracking

19:52 | 10 February

Millennials’ interest in self-care has helped to fuel an entirely new market for mobile apps focused on health and wellness. Last year alone, the top 10 meditation apps pulled in $195 million — a 52% increase from 2018, for example. A newcomer to the self-care app market is Tangerine, an app that focuses on habit and mood tracking with the goal of offering users a way to better organize their routines and achieve personal goals.

According to Tangerine’s creator Pedro Marques, he and fellow co-founder Raphael Cruzeiro built the app in their free time over the past seven months or so.

“We realized that people, in general, tend to feel better and happier when they actually have a healthier, organized routine. So building an app that would combine habit and mood tracking seemed like something that could work out,” explains Marques, of how they got started. “At the end of the day, we not only want to help people be more productive, but also more conscious, grateful and reflective of their life.”

Mood tracking apps are already commonplace across today’s App Store, thanks to the self-care app boom. However, many apps focus mainly only on allowing users to record their moods, often with a simple emoji. The app would then derive certain insights from the user’s emotional state history over time. Tangerine, on the other hand, aims to better connect how someone’s daily routine impacts how they’ve been feeling.

Your goal may be to exercise more, eat healthier, or meditate daily, perhaps. Or you may want to learn something new — like a new language or how to code. Or perhaps your aim is to improve your relationships with family, friends and loved ones. But making a commitment to change your behavior or to fit new activities into your day’s routine can be difficult. While alerts and reminders can help you to remember you’re supposed to do a certain activity, they don’t help to motivate you to do so.

Tangerine aims to be the extra push of encouragement you need and gives you the ability to reflect on your day, which the team believes is in itself a powerful motivator. The end result is an app that combines habit tracking, journaling, and mood tracking to offer an improved set of insights over mood tracking alone.

For example, Tangerine may be able to tell you things like “When your days were awesome, you completed X habits per day on average.” You can also see your completion rate broken down over time, your current streak, longest streak, a mood graph, and more.

Soon, the app plans to add integration with the iOS Health app so you’ll be able to tie these insights with other health data — like your exercise schedule or sleep cycle. That way you’ll see if completing your habits helped you sleep better, or you had a better work week when you made time to exercise, among other things.

But what makes Tangerine stand out isn’t just its feature set alone. The app’s design is compelling, as well. It’s simple, but polished in a way that you don’t always see from a scrappy side project built by a team of two.

Tangerine launched in mid-January and under a month has seen around 15,000 downloads and 2,000 daily active users. The app is currently bootstrapped and monetizes through subscriptions for premium features ($4.99/mo or $29.99/year). Because the app is still new, most subscribers are still on free trials for now. Over time, Tangerine aims to expand the premium feature set to make subscription conversions more compelling.

The self-care app market today is led by meditation apps, like Calm and Headspace, but many other top apps also offer mood tracking, mindfulness, journaling, and other self-care activities. For example, the No. 10 most-downloaded self-care app of 2019, Sanity & Self, offers audio programs, reminders, and journaling, and No. 8 app Aura includes a mood tracker, life coaching service, and community features.

As the market continues to grow, there’s room for more variety than just apps focused on meditation alone.

Tangerine is available today for iOS, but an Android version is planned for later this year.

 

 

 


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UK public sector failing to be open about its use of AI, review finds

17:56 | 10 February

A report into the use of artificial intelligence by the UK’s public sector has warned that the government is failing to be open about automated decision-making technologies which have the potential to significantly impact citizens’ lives.

Ministers have been especially bullish on injecting new technologies into the delivery of taxpayer funded healthcare — with health minister Matt Hancock setting out a tech-fuelled vision of “preventative, predictive and personalised care” in 2018, calling for a root and branch digital transformation of the National Health Service (NHS) to support piping patient data to a new generation of “healthtech” apps and services.

He has also personally championed a chatbot startup, Babylon Health, that’s using AI for healthcare triage — and which is now selling a service in to the NHS.

Policing is another area where AI is being accelerated into UK public service delivery, with a number of police forces trialing facial recognition technology — and London’s Met Police switching over to a live deployment of the AI technology just last month.

However the rush by cash-strapped public services to tap AI ‘efficiencies’ risks glossing over a range of ethical concerns about the design and implementation of such automated systems, from fears about embedding bias and discrimination into service delivery and scaling harmful outcomes to questions of consent around access to the data-sets being used to build AI models and human agency over automated outcomes, to name a few of the associated concerns — all of which require transparency into AIs if there’s to be accountability over automated outcomes.

The role of commercial companies in providing AI services to the public sector also raises additional ethical and legal questions.

Only last week, a court in the Netherlands highlighted the risks for governments of rushing to bake AI into legislation after it ruled an algorithmic risk-scoring system implemented by the Dutch government to assess the likelihood that social security claimants will commit benefits or tax fraud breached their human rights.

The court objected to a lack of transparency about how the system functions, as well as the associated lack of controllability — ordering an immediate halt to its use.

The UK parliamentary committee which reviews standards in public life has today sounded a similar warning — publishing a series of recommendations for public sector use of AI and warning that the technology challenges three key principles of service delivery: Openness, accountability, and objectivity.

“Under the principle of openness, a current lack of information about government use of AI risks undermining transparency,” it writes in an executive summary.

“Under the principle of accountability, there are three risks: AI may obscure the chain of organisational accountability; undermine the attribution of responsibility for key decisions made by public officials; and inhibit public officials from providing meaningful explanations for decisions reached by AI. Under the principle of objectivity, the prevalence of data bias risks embedding and amplifying discrimination in everyday public sector practice.”

“This review found that the government is failing on openness,” it goes on, asserting that: “Public sector organisations are not sufficiently transparent about their use of AI and it is too difficult to find out where machine learning is currently being used in government.”

In 2018 the UN’s special rapporteur on extreme poverty and human rights raised concerns about the UK’s rush to apply digital technologies and data tools to socially re-engineer the delivery of public services at scale — warning then that the impact of a digital welfare state on vulnerable people would be “immense”, and calling for stronger laws and enforcement of a rights-based legal framework to ensure the use of technologies like AI for public service provision does not end up harming people.

Per the committee’s assessment it is “too early to judge if public sector bodies are successfully upholding accountability”.

Parliamentarians also suggest that “fears over ‘black box’ AI… may be overstated” — and rather dub “explainable AI” a “realistic goal for the public sector”.

On objectivity, they write that data bias is “an issue of serious concern, and further work is needed on measuring and mitigating the impact of bias”.

The use of AI in the UK public sector remains limited at this stage, according to the committee’s review, with healthcare and policing currently having the most developed AI programmes — where the tech is being used to identify eye disease and predict reoffending rates, for example.

“Most examples the Committee saw of AI in the public sector were still under development or at a proof-of-concept stage,” the committee writes, further noting that the Judiciary, the Department for Transport and the Home Office are “examining how AI can increase efficiency in service delivery”.

It also heard evidence that local government is working on incorporating AI systems in areas such as education, welfare and social care — noting the example of Hampshire County Council trialling the use of Amazon Echo smart speakers in the homes of adults receiving social care as a tool to bridge the gap between visits from professional carers. And points to a Guardian article which reported that one-third of UK councils use algorithmic systems to make welfare decisions.

But the committee suggests there are still “significant” obstacles to what they describe as “widespread and successful” adoption of AI systems by the UK public sector.

“Public policy experts frequently told this review that access to the right quantity of clean, good-quality data is limited, and that trial systems are not yet ready to be put into operation,” it writes. “It is our impression that many public bodies are still focusing on early-stage digitalisation of services, rather than more ambitious AI projects.”

The report also suggests that the lack of a clear standards framework means many organisations may not feel confident in deploying AI yet.

“While standards and regulation are often seen as barriers to innovation, the Committee believes that implementing clear ethical standards around AI may accelerate rather than delay adoption, by building trust in new technologies among public officials and service users,” it suggests.

Among 15 recommendations set out in the report is a call for a clear legal basis to be articulated for the use of AI by the public sector. “All public sector organisations should publish a statement on how their use of AI complies with relevant laws and regulations before they are deployed in public service delivery,” the committee writes.

Another recommendation is for clarity over which ethical principles and guidance applies to public sector use of AI — with the committee noting there are three sets of principles that could apply to the public sector which is generating confusion.

“The public needs to understand the high level ethical principles that govern the use of AI in the public sector. The government should identify, endorse and promote these principles and outline the purpose, scope of application and respective standing of each of the three sets currently in use,” it recommends.

It also wants the Equality and Human Rights Commission to develop guidance on data bias and anti-discrimination to ensure public sector bodies’ use of AI complies with the UK Equality Act 2010.

The committee is not recommending a new regulator should be created to oversee AI — but does call on existing oversight bodies to act swiftly to keep up with the pace of change being driven by automation.

It also advocates for a regulatory assurance body to identify gaps in the regulatory landscape and provide advice to individual regulators and government on the issues associated with AI — supporting the government’s intention for the Centre for Data Ethics and Innovation (CDEI), which was announced in 2017, to perform this role. (A recent report by the CDEI recommended tighter controls on how platform giants can use ad targeting and content personalization.)

Another recommendation is around procurement, with the committee urging the government to use its purchasing power to set requirements that “ensure that private companies developing AI solutions for the public sector appropriately address public standards”.

“This should be achieved by ensuring provisions for ethical standards are considered early in the procurement process and explicitly written into tenders and contractual arrangements,” it suggests.

Responding to the report in a statement, shadow digital minister Chi Onwurah MP accused the government of “driving blind, with no control over who is in the AI driving seat”.

“This serious report sadly confirms what we know to be the case — that the Conservative Government is failing on openness and transparency when it comes to the use of AI in the public sector,” she said. “The Government is driving blind, with no control over who is in the AI driving seat. The Government urgently needs to get a grip before the potential for unintended consequences gets out of control.

“Last year, I argued in parliament that Government should not accept further AI algorithms in decision making processes without introducing further regulation. I will continue to push the Government to go further in sharing information on how AI is currently being used at all level of Government. As this report shows, there is an urgent need for practical guidance and enforceable regulation that works. It’s time for action.”

 


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