Blue Shield of California CEO Paul Markovich

Artificial Intelligence

Nabla Kicks Off the Year With $24M Series B

Nabla hit the ground running in 2024 with the close of $24M in Series B funding, vaulting the startup’s valuation to $180M less than year after the US launch of its Nabla Copilot ambient AI assistant.

Nabla Copilot checks all the usual boxes for an automated clinical note solution, quickly transforming patient-provider conversations into note drafts that can be customized to meet different format preferences.

• Since the US rollout in March of last year, Nabla Copilot has grown to over 20k users at small practices and larger systems alike, mostly split between primary care physicians (50%), mental health providers (30%), and a mix of other specialties.

• While Paris-based Nabla maintains a strong position in the European market, it hasn’t wasted any time finding US customers, and recently chained together marquee partnerships with Permanente Medical Group and NextGen Healthcare.

Nabla’s approach to model development is where it starts to differentiate itself from a pack of equally hungry competitors like Abridge (which just closed its own Series B) and Nuance (which is full-speed-ahead with the deployment of DAX Copilot).

• Although Nabla has historically leveraged GPT-4 to power its backend, it’s now focused on migrating toward a combination of homegrown and open source AI models like those championed by Meta AI Chief Yann Lecun, also an early investor.

• By constantly testing and fine-tuning different models for specific tasks, Nabla is aiming to be one of the most nimble companies in the medical scribe arena, while also sidestepping the hefty licensing fees charged by commercial models.

The next step for Nabla outside of breaking its reliance on OpenAI is to launch a new solution geared toward automatically generating billing codes, which could debut before the end of the quarter. Mandarin, Portuguese, and Russian translation features are also on this year’s roadmap, and would add to Nabla’s existing capabilities for English, French, and Spanish.

The Takeaway

Nabla is making its agility the driving force behind its business strategy, turning away from generalist AI models in favor of a collection of more narrow algorithms designed to excel at specific use cases. It now has another $24M to fuel the transition, and also hinted that another $10M could be on the way as early as February.

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The Wire

• MAPS Rebrands, Raises $100M: The Multidisciplinary Association for Psychedelic Studies – better known as MAPS – hauled in $100M of Series A funding to help it along the next stage of its journey, starting with a rebranding to Lykos Therapeutics. The funding will support Lykos’ ongoing research into MDMA-assisted psychotherapy for the treatment of PTSD, which Lykos is now submitting for FDA approval following the stellar results of its phase 3 trial. After just three sessions of MDMA-assisted psychotherapy, 71% of patients in the trial no longer met the criteria for a PTSD diagnosis.

• GLP-1s and Suicidal Ideation: As if GLP-1s didn’t already have enough going for them, a study in Nature Medicine added another tailwind after finding that they’re also associated with a lower risk of suicidal ideation than alternative weight loss medications. Looking at EHR data for over 240k overweight patients and 1.6M patients with Type 2 diabetes, semaglutide was associated with a 49% to 73% lower risk of suicidal ideation compared to those taking other treatments. Novo Nordisk and Eli Lilly each naturally issued statements saying they were thrilled with the results.

• Glooko + Better Therapeutics: Chronic condition management company Glooko is partnering with Better Therapeutics to integrate BT’s AspyreRx digital behavioral treatment for T2D into its diabetes management platform. Glooko’s ‘precision engagement’ functionality will enable providers on its platform to see patients who are suitable candidates for AspyreRx so that they can facilitate prescriptions and track the progress of any treatment. The collaboration should quickly accelerate AspyreRx adoption, considering that Glooko’s solutions are utilized in nearly 5,000 clinic locations across the US alone.

• Lilly Goes DTC: Eli Lilly raised some eyebrows last week with the launch of its LillyDirect platform, built to connect patients with an independent telehealth provider that would handle prescribing and delivering of its Zepbound GLP-1 obesity med. Although LillyDirect doesn’t offer any financial advantages, it provides convenient access to the drug and should help convert more of Lilly’s web visitors into Zepbound users. Whether it will provide patients with similar care as traditional routes is another story.

• AI Misdiagnoses Pediatric Cases: The Cohen Children’s Medical Center penned a research letter in JAMA Pediatrics that suggests GPT-4 is better at passing medical exams than it is at diagnosing pediatric cases. After asking GPT-4 to make diagnoses based on 100 pediatric cases published in medical journals over the past decade, the chatbot incorrectly diagnosed 72% of cases and didn’t give a specific enough diagnosis in 11%, raising more questions around how far AI is from its clinical setting debut.

• What’s UpDoc? It didn’t take long for a company to claim the title of “the world’s first AI Assistant that delivers clinical care,” which UpDoc announced as it emerged from stealth with big name backers including Eli Lilly and Mayo Clinic. UpDoc pairs an AI assistant and a smartphone app to not only monitor patients with chronic conditions in their homes, but also to intervene with tasks like medication adjustment and lab ordering as needed. The AI is “clinician directed,” meaning it adheres to physician-created plans and loops in the care team when necessary.

• TikTok Parent Eyes US Healthcare: Chinese conglomerate ByteDance, the parent company of TikTok, is hiring for at least 17 US-based roles related to “AI for Science” and “AI for Drug Design.” According to a Forbes analysis of the job listings, ByteDance is looking to revolutionize “AI-driven drug design, tackling complex challenges in protein structure prediction and computational protein design.” Many TikTok users speak openly about their medical conditions, which could provide valuable feedback throughout the drug discovery process, but the article lays out how that same data could also be used for less benign intentions.

• Smartphone TB Screening: Findings published in Science Advances showed early promise for a smartphone-based screening app for tuberculosis, which is notoriously difficult to diagnose and the second-most common cause of death from infectious disease. The TBscreen tool was trained on over 34k coughs then tested on 149 patients with TB and 46 patients with other respiratory conditions, producing about 70% sensitivity when used on cough recordings from a Google Pixel 2 smartphone (the top performer).

• K Health & Mayo’s ECG AI Alliance: AI-driven primary care company K Health entered into a know-how agreement with Mayo Clinic aimed at developing an AI solution for ECG-based risk assessments, remote patient monitoring, and treatment personalization. K Health has been licensing Mayo’s de-identified patient data to train and refine its algorithms since 2020, and the organizations also have plenty of outside co-development experience including Mayo’s recent alliance with Agamon and K Health’s partnership with Cedars-Sinai.

• Healthcare M&A Declines: Mergers and acquisitions across the healthcare industry have now fallen below pre-pandemic levels, according to a just-released KPMG report. KPMG points to the FTC’s aggressive posture on mergers as driving last year’s 14% drop to 857 transactions, as well as other factors such as inflation concerns and greater competition for a smaller number of high-value targets. Still, execs surveyed for the report were optimistic about a turnaround in 2024, with over 3 in 5 expecting more M&A, and only 9% expecting another decrease.

• Exercise Reduces Cancer Risk: New research in Cancer Cell raises the notion that exercise should be part of the conversation during cancer screening visits. Looking at data for more than 60k participants in the Prostate, Lung, Colorectal, and Ovarian screening trial, researchers found that those who exercised had a lower 20-year risk of head and neck cancer (26%), lung cancer (20%), and breast cancer (11%), but a higher risk of melanoma (20%) and prostate cancer (12%) compared to non-exercisers. Exercisers who developed cancer also had a 17% lower risk of death from any cause.

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