Amazon Announces Healthcare Accelerator Finalists

Amazon Announces Healthcare Accelerator Finalists

Digital health startups were in the spotlight this week as Amazon announced the ten finalists for its first ever AWS Healthcare Accelerator.

The companies were selected from 427 applications and 31 countries around the world, although each finalist is US-based. The finalists were chosen by a panel from Amazon Web Services (AWS) and KidsX, an accelerator for companies focusing on pediatric care. Each startup has a validated solution along with existing revenue and customers.

The AWS Healthcare Accelerator is a four week program that pairs finalists with technical and business mentorship from experts from AWS and KidsX, then offers collaboration opportunities with members of the AWS Partner Network looking for healthcare solutions.

AWS Healthcare Accelerator finalists include:

  1. AIVA is a voice-powered care assistant for hospital patient rooms and senior living communities with a mission to be the voice operating system for better care. 
  1. b.well offers an integrated solution for consumer engagement, holistic health management, and cost containment. They use longitudinal aggregated data to paint a picture of health for each consumer and aggregate data to show population health.
  1. Ejenta automates remote monitoring and remote care delivery using AI exclusively licensed from NASA. Their “intelligent agents” learn from connected devices and EHR data to monitor patients, predict health, and connect care teams.
  1. Giblib creates an educational content streaming experience for healthcare providers. It allows for on demand streaming of surgical videos and medical lectures from subject matter experts along with the ability to receive continuing education credits.
  1. Gyant is a virtual assistant and digital front door solution designed to optimize patient journeys. It navigates patients to the right care setting and resources while providing simple appointment scheduling.
  1. Kaizen Health is a healthcare logistics platform that connects healthcare and transportation to reduce access barriers.
  1. Medical Informatics Corp offers an FDA-cleared Sickbay virtual care platform that helps hospitals improve operational efficiencies by enabling the rapid scaling of remote patient monitoring across any inpatient setting.
  1. Neuro Rehab VR is reinventing training exercises for physical and cognitive therapy by leveraging VR and neuroplasticity for recovery. It allows providers to track their patients in real time and has shown increased patient engagement.
  1. OneRecord provides an app that helps patients build a consolidated health record of their entire medical history in a single place.
  1. Pieces uses AI to connect patients and health systems with solutions that address social determinants of health. They connect care providers to actionable data, people to services, and caseworkers to information.

Industry Impact

Amazon’s multi-pronged strategy for entering the healthcare market goes beyond its hands-on approach with Amazon Care. By providing companies such as these finalists with AWS solutions, Amazon is establishing itself as the cloud-based foundation for a new cohort of healthcare disruptors.

Verily Starts Planning for Life After Google

Alphabet’s life sciences division Verily is working to distance itself from Google technology as it plans for the next phase of its products and a possible future outside of its parent company, according to reporting from Insider.

The project known internally as Flywheel began in 2021 and involves transitioning Verily’s products away from Google’s internal cloud to a public version of the tech infrastructure.

Internal documents appear to reveal that an initial version of Verily’s updated technology stack is set to arrive by early next year.

  • Verily is aiming for independence. As the company matures, it is looking to diversify its product offerings into new areas such as telehealth, but potential partners have often needed reassurance that Verily’s data would not be shared with Google.
  • Flywheel could signal an IPO. Verily CEO Andy Conrad has previously mentioned a push towards an initial public offering, although the pandemic pushed back those plans. A current employee interviewed by Insider confirmed that an IPO is “the carrot Andy is always dangling in front of us.”
  • Verily’s recent moves support the theory. It raised $700m in late 2020 before acquiring clinical trial management system SignalPath in August to expand its commercial offerings. It also recently partnered with Mayo Clinic to develop a clinical decision support tool, all while bolstering its leadership team.

The Takeaway

When Google reorganized as Alphabet in 2015, the structure was designed to give subsidiaries more flexibility to expand away from the company’s core operation. Although no large companies have yet to be spun out, the Flywheel project makes Verily look like a strong contender to be the first one. Possibly as early as next year.

Xealth Makes Digital Health Usable

The booming digital health sector has seen such rapid expansion that it is beginning to enter the next level of its industry life cycle: the stage where solutions have solutions.

Digital health integration platform Xealth recently closed $24m in Series B funding, bringing the Providence St. Joseph Health spinoff’s total funding to $52.6m.

Xealth aggregates and organizes digital health tools within the EHR, enabling not only easier reporting, but also centralized distribution, enrollment, and patient monitoring.

The Xealth platform has three interdependent modules:

  • Xealth Clinical Interface – Solutions are ordered, delivered, and tracked from within the EHR, with clinical decision support matching patients to relevant solutions.
  • Xealth Digital Command Center – Provides customized reporting of patient and provider engagement, which is aggregated to match demographics to solutions.
  • Xealth Integration Layer – Supports deployment of multiple solutions through a single integration with the EHR, allowing health systems to save IT resources by avoiding independent vendor integration.

The Takeaway

As health systems pursue innovation, they’re presented with an abundance of disjointed products with specialized use cases, creating the need for a platform that allows physicians to prescribe and monitor these solutions within a single cohesive workflow.

Xealth’s services are already available to over 100k physicians, and the company states that care teams are seeing improved patient engagement metrics as a result of measuring outcomes across a health system’s entire virtual solution ecosystem.

Aggregators that improve usability of existing solutions have emerged as success stories in other industries such as business collaboration software, and Xealth is looking to replicate this success within the digital health landscape.

Under the Radar Healthcare Disruptors

Digital health venture fund and advisory team Rock Health recently published an excellent blog post outlining what they call healthcare’s “middle children,” defined as large-but-not-huge companies that should be eyeing expansion into healthcare.

The authors argue that these middle children have distinct competitive advantages over the cohort of technology giants that have recently been pursuing the healthcare space, which include the likes of Amazon, Alphabet, and Apple.

  • Middle children with market capitalizations between $10b and $350b are large enough to make an impact in healthcare, but small enough to avoid the scrutiny of massive players. They are often consumer-facing, with business lines that could pivot towards a healthcare use case (picture Lululemon’s acquisition of Mirror).
  • Larger middle children have deep pockets and talents pools (Salesforce, Nike), with the capabilities to pursue large healthcare goals.
  • Smaller middle children have more specialized capabilities (Garmin, Airbnb), that could help with solving more focused problems.

Middle Children Advantages

  • Smaller healthcare goals are big enough for middle children to pursue for growth, whereas much larger companies need loftier projects to warrant market expansion.
  • Loyal customer bases can be activated by middle children to establish initial users while avoiding the regulatory attention quickly drawn by larger competitors.
  • Specialized assets from middle children, such as logistics expertise or data analytics, can provide a competitive edge in healthcare. 

Potential Middle Children Plays

  • Blizzard could passively monitor behavioral health conditions for children playing its games
  • Paypal could integrate Health Savings Accounts to help users manage healthcare spending
  • Hello Fresh could offer health insights and recommend food products for delivery

The Takeaway

Gaining share within the $3.5t US healthcare market is a powerful motivator for any company looking to pursue a strategy shift, but even consumer-favorite brands will need humility to navigate the complex and quickly evolving environment.

Although middle children don’t specialize in the sector, Rock Health makes a solid case that they might be some of the best-positioned companies for healthcare disruption, and I wouldn’t be surprised if we’re reading about some of the plays listed in this blog post in next year’s business news.

Pandemic Lessons Led to Google Health Shakeup

The recent dismantling of Google Health following the departure of its chief, David Feinberg, MD, could easily have been interpreted as evidence that the company was retreating from healthcare.

To clear up any confusion, Google Chief Health Officer Karen DeSalvo, MD, spoke with Bloomberg about the search giant’s reorganization. She revealed that the changes reflect a shift in focus related to Google’s work during the pandemic, and that the company is in no way “retrenching on health.”

For Google, the pandemic was an unexpected crash course in health sector operations, expediting many of the lessons that could otherwise have taken years.

Dr. DeSalvo stated that the company’s work on services ranging from contact tracing to population mobility tracking played a large role in the decision to restructure its health unit.

  • Google’s old strategy revolved around consolidating the company’s wide ranging healthcare efforts, such as disease detection and clinical decision support, into a centralized product unit to be commercialized. Dr. Feinberg was hired in 2019 to lead the new division, Google Health, but his team members were disbanded into research and wearables units shortly after his departure.
  • Google’s new strategy is an effort to embed healthcare initiatives into its core products, such as Search and YouTube, rather than launching independent commercial services. This strategy is designed to have a wider influence on health by meeting consumers where they already are.

Industry Impact

With a majority of Google’s revenue coming from advertising, working with sensitive health data quickly attracts attention from regulators. One of Google Health’s early projects under Feinberg got particularly messy when a search tool created for the Ascension hospital network prompted a federal inquiry over data privacy concerns.

Although the Ascension search tool is still operational and secure, Dr. DeSalvo admits that the company must tread carefully when navigating the healthcare space, but believes that the reorganization will help to deliver superior medical care and human outcomes.

Invitae Acquires Ciitizen to Make Genomics Accessible

Genetic testing leader Invitae recently acquired consumer health tech company Ciitizen for $325m, split between $125m and approximately 7m shares of Invitae stock.

While a medical genetics business and a digital record compiler share few similarities at first glance, the strategy behind the deal comes into focus when looking at the driving themes behind each company.

  • Ciitizen is a patient-centric platform that enables users to organize their medical records in order to optimize their own care or contribute the data towards a different goal, such as rare disease research. CEO Anil Sethi founded Ciitizen in 2017 after having a difficult time accessing his sister’s health records while she was battling cancer. 
  • Invitae is on a mission to bring comprehensive genetic information to mainstream medicine. The company is attempting to aggregate global genetic test results into a single user-friendly service that makes the information accessible to anyone with patient consent.
  • Both companies share a common goal that might be better served by working together: data accessibility. Whether unstructured health records or disjointed genetic test results, each business is seeking to improve the utility of hard-to-reach data.

The Takeaway

As genomics transitions from a laboratory testing-based industry to an information industry, Invitae is aiming to develop a platform that allows patients to make use of their data. The acquisition of Ciitizen gives Invitae the ability to create a centralized hub for genomic and clinical information, a dynamic dataset with the potential to drive better research and health outcomes.

Amazon Care is Coming to a City Near You

Amazon is expanding its in-person medical care service to 20 cities by the end of next year, causing many digital primary care providers to begin wondering how much disruption is on the way.

  • What is Amazon Care? The service offers virtual primary care through an app, connecting users to physicians with messages and video in as little as 60 seconds. For in-person care, nurses are dispatched to patients’ homes for tests and treatment, as opposed to patients travelling to an office.

Amazon Care began as an employee-only health service for the company’s own workers, but recently opened up to other US-based employers.

In-person care was originally limited to Washington state, Washington DC, and Baltimore, but is now set to reach Philadelphia, Chicago, Dallas, and Boston in 2021 – at least according to “three people familiar with the plans” speaking to Business Insider.

  • Is Amazon Care coming to your city in 2022? Yes… as long as you live in Atlanta, Denver, Detroit, Houston, Indianapolis, Kansas City, Los Angeles, Miami, Minneapolis, Nashville, Tennessee, New York, Phoenix, Pittsburgh, San Francisco, San Jose, or St. Louis.

Although the expansion announcement might seem as innocuous as a young Jeffrey Bezos telling you he’s starting to sell books on the internet, Amazon’s success in industries ranging from e-commerce to cloud computing suggests that healthcare could be next.

The $3T US healthcare market is notoriously difficult to disrupt, and Amazon Care’s unique approach of sending clinicians to patient homes is an enormous logistical problem, but that might make the company behind 2-day free shipping the best one to solve it. 

Although Amazon’s recent healthcare ventures haven’t had an industry-altering impact, the company has a long history of experimenting, learning lessons from failures, and making a better product down the road. Amazon Care might be that product.

Verily Aims to Build GPS for Patient Care

Mayo Clinic and Verily, Alphabet’s life science division, recently announced a two-year strategic partnership to develop a clinical decision support (CDS) tool that caters to a patient’s individual needs. 

Although physicians generally do not love their EHR flashing advice at them, the collaboration aims to sidestep the one-size-fits-all approach of traditional CDS tools with AI-generated recommendations relevant to the patient in the room.

  • The Partnership – Mayo Clinic will provide curated clinical content and deidentified health record data while Verily will apply advanced analytics and user-centered design to deliver insights within existing point-of-care workflows.
  • The Roadmap – The tool will initially focus on cardiovascular and cardiometabolic conditions at Mayo Clinic, but will use open standards to enable integration with multiple EHRs for possible expansion to other use cases for Verily’s health system partners.

The Takeaway

While announcing the partnership, medical director of Mayo Clinic’s Center for Digital Health Bradley Leibovich MD stated that he hopes the tool can be used as “a GPS for patient care.”

The companies cited the exponential growth in medical discovery and knowledge as making it  nearly impossible for caregivers to keep up with the latest advances in their fields, creating a need for a tool that offers clinical support. 

Verily and Mayo Clinic are betting that their combined expertise in clinical informatics and data science will be the solution to creating a patient-relevant CDS that clinicians actually want to use.

Apple Takes a Step Back From Healthcare

According to a new report from Business Insider, Apple is scaling back its internal HealthHabit app that let employees track their fitness, talk to clinicians, and manage hypertension. 

HealthHabit was one of Apple’s largest projects resulting from a partnership with AC Wellness, a primary care provider for employers and families. Unnamed sources at Apple stated that HealthHabit was intended for a consumer launch if successful internally, which… it apparently wasn’t.

Although the project was the focus of more than 50 employees, it struggled with user engagement, a problem all too familiar to those working on digital health products.

  • The Strategy – Apple’s healthcare ambitions are apparent in its products, with the company incorporating a medical-grade EKG in the Apple Watch and data-sharing for clinical trials through the iPhone Health app. HealthHabit’s roadmap likely resembled that of Amazon Care, which began as an employee-only primary care app before expanding nationwide earlier this year.
  • The Trend – Apple’s news follows just days after Alphabet reported that it was dismantling Google Health and reorganizing its healthcare projects to be closer to their team-specific specialties (e.g. Health-AI moves within AI group). Sometimes taking a step back is the best way to move forward, and Apple’s recent moves are far from the end of its healthcare strategy. 

The healthcare history books are filled with would-be disruptors who seemed to have everything they needed (excellent teams, funding, strong industry connections), but few if any have had the bottomless warchest of capital and talent commanded by Apple.

While the moat around healthcare is incredibly wide (entrenched tech/vendors, complex datasets, demanding users), the same could be said about the smartphone market circa 2008.

Despite this step back, if any industry needs a disruptor, it’s healthcare – and if any consumer brand is going to pull it off, it’s Apple.

The Mental Health Mega-Merger

At a time when mental health problems are rapidly escalating, Headspace and Ginger have a solution: mega-merger.

Meditation app Headspace is merging with teletherapy platform Ginger to create a combined company called Headspace Health. The agreement values the joint venture at $3b (10x this year’s expected revenue) and will give Headspace Health the ability to begin offering affordable mental health services to over 100 million people globally. 

  • Headspace – The company is best known as one of the first guided meditation apps and remains a leader in mindfulness training. Headspace has partnerships with many consumer-favorite brands such as Netflix and Spotify, giving many of those suffering from anxiety and depression their first exposure to accessible care.
  • Ginger – Ginger offers its members access to mobile-first mental healthcare, including behavioral health coaching and telehealth therapy. It has an on-demand, team-based care model, giving users 24/7 access to therapists.
  • Headspace Health – The newly formed company will blend Headspace’s 65m+ user base with Ginger’s evidence-based interventions, creating an easy way for patients to improve their well-being from a unified platform. Headspace Health will also have one of the world’s largest mental health data sets, which it will leverage to deliver highly personalized care.

Industry Impact

Headspace Health plays at the intersection of the mental health crisis and telemedicine, two areas that have been attracting significant investor attention. With so much capital flowing into the space, consolidation was soon to follow, and this merger could kick off a wave of similar deals involving other popular meditation apps such as Calm.

Competing acquisitions aren’t the only change foreshadowed by the merger. Headspace Health was originally the name of Headspace’s 2018 digital therapeutic product that failed to receive FDA approval, and it’s now easier to see how federal clearance, and reimbursement, could be on the horizon.

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