Wij willen met u aan tafel zitten en in een openhartig gesprek uitvinden welke uitdagingen en vragen er bij u spelen om zo, gezamelijk, tot een beste oplossing te komen. Oftewel, hoe kan de techniek u ondersteunen in plaats van dat u de techniek moet ondersteunen.

Amazon has acquired Health Navigator, a startup that develops APIs for online health services. According to CNBC, which first reported the deal, Health Navigator will become part of Amazon Care, its pilot healthcare service program for employees.

This is the second health startup acquired by Amazon. The first was online pharmacy PillPack, purchased by the company in 2018 for slightly less than $ 1 billion. PillPack’s services have also been integrated into Amazon Care, which offers deliveries of prescriptions with remotely communicated treatment plans.

Health Navigator’s platform was created to be integrated into online health services, including telemedicine and medical call centers, to standardize the process of working with patients. Its platform includes natural language processing-based tools for documenting health complaints and care recommendations, and is integrated into apps with APIs.

The startup, founded in 2014 by physician David Thompson, has not made a public statement about the acquisition yet, but CNBC reports that the company telling customers that their contracts will not be renewed.


TechCrunch

All over the globe, the population of people who are aged 65 and older is growing faster than every other age group. According to United Nations data, by 2050, one in six people in the world will be over age 65, up from one in 11 right now. Meanwhile, in Europe and North America, by 2050, one in four people could be 65 or over.

Unsurprisingly, startups increasingly recognize opportunities to cater to this aging population. Some are developing products to sell to individuals and their family members directly; others are coming up with ways to empower those who work directly with older Americans.

BrainCheck, a 20-person, Houston-based startup whose cognitive healthcare product aims to help physicians assess and track the mental health of their patients, is among the latter. Investors like what it has put together, too. Today, the startup is announcing $ 8 million in Series A funding round co-led by S3 Ventures and Tensility Venture Partners.

We talked earlier today with BrainCheck cofounder and CEO Yael Katz to better understand what her company has created and why it might be of interest to doctors who don’t know about it. Our chat has been edited for length and clarity.

TC: You’re a neuroscientist. You started BrianCheck with David Eagleman, another neuroscientist and the CEO of NeoSensory, a company that develops devices for sensory substitution. Why? What’s the opportunity here?

YK: We looked across the landscape, and we realized that most cognitive assessment is [handled by] a subspecialty of clinical psychology called neuropsychology, where patients are given a series a tests and each is designed to probe a different type of brain function — memory, visual attention, reasoning, executive function. They measure speed and accuracy, and based on that, determine whether there’s a deficit in that domain. But the tests were classically done on paper and it was a lengthy process. We digitized them and gamified them and made them accessible to everyone who is upstream of neuropsychology, including neurologists and primary care doctors.

We created a tech solution that provides clinical decision support to physicians so they can manage patients’ cognitive health. There are 250,000 primary care physicians in the U.S. and 12,000 neurologists and [they’re confronting] what’s been called a silver tsunami. With so many becoming elderly, it’s not possible for them to address the need of the aging population without tech to help them.

TC: How does your product work, and how is it administered?

YK: An assessment is all done on an iPad and takes about 10 minutes. They’re typically administered in a doctor’s office by medical technicians, though they can be administered remotely through telemedicine, too.

TC: These are online quizzes?

YK: Not quizzes and not subjective questions like, ‘How do you think you’re doing?’ but rather objective tasks, like connect the dots, and which way is the center arrow pointing — all while measuring speed and accuracy.

TC: How much does it cost these doctors’ offices, and how are you getting word out?

YZ: We sell a monthly subscription to doctors and it’s a tiered pricing model as measured by volume. We meet doctors at conferences and we publish blog posts and white papers and through that process, we meet them and sell products to them, beginning with a free trial for 30 days, during which time we also give them a web demo.

[What we’re selling] is reimbursable by insurance because it helps them report on and optimize metrics like patient satisfaction. Medicare created a new code to compensate doctors for cognitive care planning though it was rarely used because the requirements and knowledge involved was so complicated. When we came along, we said, let us help you do what you’re trying to do, and it’s been very rewarding.

TC: Say one of these assessments enables a non specialist to determine that someone is losing memory or can’t think as sharply. What then?

YZ: There’s phrase: “Diagnose and adios.” Unfortunately, a lot of doctors used to see their jobs as being done once an assessment was made. It wasn’t appreciated that impairment and dementia are things you can address. But about one third of dementia is preventable, and once you have the disease, it can be slowed.  It’s hard because it requires a lot of one-on-one work, so we created a tech solution that uses the output of tests to provide clinical support to physicians so they can manage patients’ cognitive health. We provide personalized recommendations in a way that’s scalable.

TC: Meaning you suggest an action plan for the doctors to pass along to their patients based on these assessments?

YZ: There are nine modifiable risk factors found to account for a third of [dementia cases], including certain medications that can exacerbate cognitive impairment, including poorly controlled cardiovascular health, hearing impairment, and depression. People can have issues for many reasons — multiple sclerosis, epilepsy, Parkinson’s — but health conditions like major depression and physical conditions like cancer and treatments like chemotherapy can cause brain fog. We suggest a care plan that goes to the doctor who then uses that information and modifies it. A lot of it has to do with medication management.

A lot of the time, a doctor — and family members — don’t know how impaired a patient is. You can have a whole conversation with someone during a doctor’s visit who is regaling you with great conversation, then you realize they have massive cognitive deficits. These assessments kind of put everyone on the same page.

TC: You’ve raised capital, how will you use it to move your product forward?

YK: We’ll be combining our assessments with digital biomarkers like changing voice patterns and a test of eye movements, and we have developed an eye-tracking technology and voice algorithms, but those are still in clinical development; we’re trying to get FDA approval for them now.

TC: Interesting that changing voice patterns can help you diagnose cognitive decline.

YK: We aren’t diagnosing disease. Think of us as a thermometer that [can highlight] how much impairment is there and in what areas and how it’s progressive over time.

TC: What can you tell readers who might worry about their privacy as it relates to your product?

YK: Our software is HIPAA compliant. We make sure our engineers are trained and up to date. The FDA requires that we we put a lot of standards in place and we ensure that our database is built in accordance with best practices. I think we’re doing as good a job as anyone can.

Privacy is a concern in general. Unfortunately, companies big and small have to be ever vigilant about a data breach.


TechCrunch

French startup Alan announced new products, international expansion plans and a brand refresh at a press conference this morning. The company also announced plans to overhaul some of its tech stack to improve the overall user experience.

Alan is a software-as-a-service startup that offers health insurance in France. The company wants to create a well-designed insurance product with transparent pricing and policies to make healthcare more accessible. The startup has obtained an official health insurance license and raised around $ 86 million over the years.

Until today, Alan offered insurance products to companies and freelancers. The startup is greatly expanding its potential user base by addressing new markets.

“Our users are smart. We already had users for all products that we’re launching today, but they were working around the rules,” co-founder and CEO Jean-Charles Samuelian said.

First, Alan is launching specific insurance products for the hospitality industry (hotels and restaurants). Companies and employees can sign up directly from the mobile app as people working in the hospitality industry don’t sit in front of a computer all day long.

These insurance products are now compliant with legal requirements for the hospitality industry. There are two different tiers, Alan Cerises with basic coverage for €30 per month and Alan Pomme with better coverage for €55 per month. As always, companies pay at least 50 percent of health insurance, employees pay the rest.

Alan is also launching an insurance product for individuals, not just freelancers. And it opens up three new segments — individuals who don’t work for a French company or have specific needs, retired people and public servants.

Starting today, teachers, retired people looking for a digital insurance product and other individuals can sign up to Alan. Pricing depends on your age. It ranges from €46 per month if you’re 18, €62 per month if you’re 30, €83 per month if you’re 50, €133 per month if you’re 70, etc.

Alan Lockup Horizontal Green RGB Large

When it comes to branding, Alan has worked with James Vincent on a new logo, a new color palette, a new mascot design, etc. The company is also launching a TV ad.

“Our mission is to be more than a health insurance company, we want to be your health ally,” Samuelian said.

Alan also shared some details about future product updates and business updates. The company is going to expand to other countries starting next year.

After looking at other European markets, Alan is going to focus on Spain and Belgium first. The startup doesn’t need to re-apply to a local license as it can passport its insurance license all around Europe.

Alan has also been working on a big overhaul of its tech stack. The company has been working with a third-party company to handle payments and reimbursements in order to launch more quickly.

But Alan started working on its own payment system. 30 percent of the engineering team is going to work on that project from May 2019 to December 2019. And the goal is to make payments 10 times faster after the switch. Sending a dentist or optician quote to see if Alan is going to cover you is going to be much faster as well.

There are now 126 people working for Alan. 2,850 French companies use Alan to cover 37,000 people. It represents $ 31 million in annual recurring revenue (€28 million). And the company still has a ton of cash on its bank account — around $ 61 million (€55 million).

Over the next 12 months, the company wants to cover 100,000 people and have a team of 250 employees. In other words, things are looking good.


TechCrunch

There has long been a stigma associated with therapy and mental health coaching, a stigma that is even more pronounced in the business world, despite considerable evidence of the efficacy of these services. One of the organizations that has set out to change this negative association is Torch, a startup that combines the therapeutic benefits of executive coaching with data-driven analytics to track outcomes.

Yet, as Torch co-founder and CEO Cameron Yarbrough explains in this Breaking Into Startups episode, the startup wasn’t initially a tech-oriented enterprise. At first, Yarbrough drew on his years of experience as a marriage and family counselor as he made the transition into executive coaching, even referring to the early iterations of Torch as little more than “a matchmaking service between coaches and professionals.”

In time, Yarbrough identified a virtually untapped market for executive coaching — one that, by his estimate, could amount to a $ 15 billion industry. To demonstrate to investors the great potential of this growing market, he first built up a clientele that provided Torch with sufficient recurring revenue and low churn rate.

Only then was Yarbrough able to raise a $ 2.4 million seed round from Initialized Capital, Y Combinator, and other investors, convincing them that data analytics software could enhance the coaching process — as well as coach recruitment — enough to effectively “productize feedback,” as he puts it.

For Yarbrough and Torch, “productizing feedback” involves certain well-known business strategies that complement traditional coaching methods. For instance, Torch’s coaching procedure includes a “360 review,” a performance review system that incorporates feedback from all angles, including an employee’s manager, peers, and other people within an organization who have knowledge of the employee’s work.

The 360 review is coupled with an OKR platform, which provides HR departments and other interested parties with the metrics and analytics to track employee progress through the program. This combination is designed to promote the development of soft skills, which in turn drive leadership.

Torch has achieved considerable success, landing several influential clients in the tech sector through its B2B approach. But Yarbrough is clear that his goal with the company is to “democratize” access to professional coaching, in hopes of providing the same kind of mental health counseling and support to employees in all levels of an organization.

In this episode, Yarbrough discusses the history and trajectory of Torch, his experience scaling a company many considered unscalable, and the methods he uses to manage his own emotional and mental health as the CEO of an expanding startup. Yarbrough offers insights into the feelings of anxiety and dread common among entrepreneurs and provides a close look at how he has found business and personal success with Torch.


Breaking Into Startups: There’s a difference between a mentor and a coach. Today, I want to talk about that difference and in addition to the intersection between business and psychology, What Cameron Yarbrough, CEO of Torch and Founder of Well Clinic.

If you’re someone that is looking for a mentor or a coach as you break into tech, or if you just want to be surrounded by peers, make sure you download the Career Karma app by going to www.breakingintostartups.com/download.

On today’s episode, you’re going to understand the importance of therapy, mental health and coaches, as well as how historically, it has been inaccessible to people and how Cameron is using his background to democratize this for the world.

If this is your first time listening to the Breaking Startups Podcast, make sure you leave a review on iTunes and tell your friends. Listen to it on Soundcloud and talk about it on Spotify. If you have any feedback for us, positive or negative, please let us know. Without further ado, let’s break-in.

Cameron Yarbrough is the CEO of Torch. He’s one of the best executive coaches in the world. Not only are we going to be talking about coaching and mentoring for executives, but we’ll also be talking about coaching in general for everyone. We’re going to go into how he created his company.


TechCrunch

Silicon Valley is obsessed with growth. And for digital health startups, that obsession is not only misguided, but dangerous.

The prevailing idea in the tech industry is that to succeed, you have to be ready to sell your idea, no matter how far along your idea really is. You’re encouraged to believe in your product even when there is no product to believe in.

And if you’re disrupting the mattress industry or the eyewear sector, maybe that’s okay.

But digital health startups must be held to a different and higher standard. We touch people’s lives, often when they are at their most vulnerable.

The healthcare startups in the news recently — Theranos, uBiome, Nurx, eClinicalWorks, Practice Fusion — seem to have lost sight of that crucial standard. We’ll never know every detail of what happened in these organizations, but one thing seems clear: In the pursuit of growth, they have put the patient second, and suffered as a result.

Where we went wrong

In the early days of digital health, I think we were much more focused on the patient than we are now. When I think of the early digital health companies — not just Propeller, but Omada Health, WellDoc, Ginger.io and Mango Health — all of their founders had an innate understanding of the importance of health outcomes. They craved proof that their product worked. They might have “faked it” a little bit when it came to their plans to scale — we all thought things would happen faster than they have — but when it came to research, they had answers, or a concrete plan to get answers.

My first conversation with Propeller’s co-founder and CEO, David Van Sickle, was illustrative of this. I met David at the geekiest of health conferences, Health Datapalooza. We talked about how sensors on medicines could improve people’s health. We talked about study designs and methods to generate data quickly in the real world, long before “real-world evidence” was all the buzz. We talked about a 500-person randomized controlled trial they were about to begin, immediately following FDA clearance of the system.

We talked — almost exclusively — about how Propeller could improve people’s lives, and how to prove that it worked.

So when did the digital health sector get away from that focus? And how do we get back to it?

I have a few theories on what went wrong.

First, it’s incredibly difficult to prioritize the patient as a digital health company when your investors are pushing for growth above all else. At Propeller, we were very lucky to have investors who understood our focus on making a product that worked, especially when growth was slow. Early digital health companies were funded like tech companies, with small amounts of money at a time and a need to show significant progress in 18-24 months to get the next round of funding. In contrast, life science companies are funded more heavily from the start, knowing there is a long road ahead of product development and clinical validation.

When I look at a company like uBiome, which may have rushed its tests through physician approval to meet aggressive growth targets, I see the effects of a culture and funding environment that pushes companies to deliver on growth first and foremost, no matter the tactics it takes to do so.

Product, then proof, then commercialization.

Second, we had a flood of founders and investors enter digital health from outside of healthcare.

I think digital health absolutely needs people, ideas and energy from outside the industry in order to change healthcare. But we also need everyone to learn the basics of how innovation occurs in a clinical setting: Product, then proof, then commercialization. Many of these new entrants were not just naive; they flaunted laws and “traditional healthcare” methods (and people) because they were deemed outdated and unnecessary.

They were aiming for disruption, not integration, and in doing so were ignoring the vast set of protections and people that have been put in place to ensure public safety.

The result is a glut of companies that have tried to scale growth before proving their product worked, which comes with tremendous risk. It can give patients and their physicians incorrect information leading to incorrect treatment. It can waste money on unneeded products. And it can impact the credibility of the entire digital health ecosystem.

Rebuilding a culture of outcomes

To fix this, we have to change the way we think about success in digital health, and that responsibility falls on many different parties.

The media has to be more critical of how it covers burgeoning digital health startups, prioritizing coverage of peer-reviewed research and proven outcomes over funding rounds and hiring numbers. The speaking circuit has to laud founders who can talk about how their products have changed people’s lives for the better, rather than giving the main speaking slot to the biggest exit of the year. And the investor community has to be patient with its investments, understanding that true growth in healthcare takes time.

And most of all, digital health startup founders have to be patient with themselves. I’ve been in the trenches of digital health; I know how hard it can be. But when things are tough and it’s easy to lose focus, you have to think to yourself, “Do I want to be in the headlines for astonishing growth now, and accusations of cutting corners in two years? Or am I okay with sacrificing temporary stardom for a product that actually helps people?”

This is not an easy choice to make. But if digital health is going to survive and scale, it’s one we have to make on a daily basis. Move slowly, and prove things: It’s the only way to create the kind of long-term change we’re seeking.


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