healthcare industry
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Careteam aims to unite patients and healthcare providers with a platform approach
How best to untangle the Gordian knot that is navigating your own healthcare? It’s a tricky question, and one that seems to have become only more complicated as technology improves, in many regards — systems don’t necessarily speak to one another, and it’s still hard for an ordinary patient without specialist knowledge to make sense of everything. Careteam is a Canadian startup hoping to address that, looking to replicate the kind of advances made possible by technology in industries like e-commerce and enterprise software.
Careteam co-founder and CEO Dr. Alexandra Greenhill has experienced the frustration of being a tech-savvy person in a world of healthcare that can seem technologically inept — both as a practicing GP and as someone who depends on the healthcare system as a patient and a relative of patients with more sophisticated medical needs.
“I spent more than 15 years innovating within the healthcare system,” Greenhill told me in an interview. “I computerized hospitals, helped doctors adopt electronic medical records and other types of innovation practices. And then for the last eight years, I’ve been in tech, trying to figure out how to build the kind of technology we need in health, and especially digital health.”
All that experience led Greenhill to the realization that while there were many companies building specific solutions for real, but relatively narrow problems, that didn’t reflect how most people experienced care. Greenhill and her team of three other co-founders (Jeremy P. Smith, Robert I. Atwell and Kevin Lysyk) had all had unfortunate, but eye-opening experiences with family members in need of treatment for major diseases.
“You step in and you discover that cancer care, palliative care, post-surgical care — there’s so many things that would have gone wrong if we didn’t have the expertise ourselves,” Greenhill said. “But in the meantime, you end up being sort of pulled into multiple directions and saying ‘this makes no sense.’ You know, I can purchase stuff online in my private life; I can use all kinds of tools in the business world, and yet it’s back to paper and voice in health, which matters most.”
Careteam CEO and founder Dr. Alexandra Greenhill
What Careteam provides is collaboration for care — true collaboration, designed to span patients, their doctors and other healthcare pros, their families and anyone who matters to them in the course of pursuing their care. It provides the ability to communicate instantly, build care plans that integrate all aspects of their tailored health plans, receive custom-configurable notifications and measure progress toward specific goals set by patient and healthcare providers.
Part of the reason this process has become opaque or difficult is precisely due to innovation: Greenhill takes issue with the prevailing narrative that the healthcare industry is somehow allergic to innovation.
“There’s this sort of perception that healthcare doesn’t innovate, but it’s also almost insulting to the healthcare system, because we have innovated — we save people from cancer, where we couldn’t,” she noted. “We cure HIV, in some cases, and we prevent it from being transmitted to unborn babies of mothers with full-blown AIDS and things that in my working lifetime were impossibilities; it was science fiction to help someone with HIV. And, and we’ve managed to do all of that, and it’s a success story. We’ve created complexity, we’ve created people who live with 12 conditions for many, many years and take complicated drug regiments.”
In addition to advances in treatment, Greenhill notes that she and her team couldn’t have build Careteam five years ago, because cloud storage wasn’t secure and everything had to be done on a site-specific instance, and that would’ve been cost-prohibitive to build. In other words, technology has been applied to, and vastly improved, healthcare overall, regardless of the general perception of the industry as an innovation laggard.
That’s why Greenhill’s startup doesn’t shy away from complexity — they embrace it. Careteam is designed not to try to normalize and standardize the varied and highly specialized landscape of healthcare solutions and providers through anything like a one-size-fits-all API. Instead, the company’s tech development is cleverly designed to be flexible when it comes to integrations.
“We collectively spent $1.9 billion in Canada, to try and digitize the healthcare system, create standards and create some exchange between data,” Greenhill said. “The NHS tried the same, big U.S. hospital systems have created their own little sort of islands, including Kaiser and Mayo and others. And the conclusion of all of that is standardization in healthcare just doesn’t seem to catch on.”
Careteam’s approach has been instead to integrate specific clinics, and let practitioners and patients derive benefits and help spur the adoption of the platform to their companion organizations and clinics. It’s a sort of rhizomatic approach that starts with a node central to a patient’s care and spreads through the healthcare professionals and members of the patient’s support network that the product helps. And integration is made possible without technical demands on the part of partners thanks to the work of CTO Lysyk, according to Greenhill.
The Vancouver-based startup is working with the Centre for Aging + Brain Health in Toronto, Ontario in a validation program announced last year, and also raised an initial round of funding in January led by BCF Ventures with participation from Right Side Capital, Globalive Capital, Atrium Ventures, and angels Barney Pell and Ajay Agarwal .
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As concerns over medical device security rise, MedCrypt raises $5.3 million
As medical devices move to networked technologies, securing those devices becomes increasingly important.
Regulators, seemingly late to the threat that unsecured medical devices posed, only began requiring protections for medical devices like pacemakers and insulin pumps two years ago, and since then new technology companies have leapt into the breach to begin providing security services for the healthcare industry.
Most recently, MedCrypt, a graduate from the most recent batch of Y Combinator companies, raised $5.3 million in a new round of funding, from investors led by Section 32, the investment firm founded by former Google Ventures partner Bill Maris.
Joining Maris’ firm were previous investors Eniac Ventures and Y Combinator itself.
“Internet-connected medical technology is entering the market at light speed, calling for devices to be secure by design, which leads to a heightened level of patient safety at all times,” said MedCrypt chief executive Mike Kijewski in a statement.
Securing patient data has been a longtime requirement for health technology companies, but both patient records and hospital networks are dangerously vulnerable to cyberattacks.
In 2018, more than 6 million patient records in the U.S. were exposed thanks to network intrusions and cyberattacks, according to the publication Health IT Security. And those were just in the 10 largest security breaches.
The healthcare industry has only managed to achieve 72% compliance with the HIPAA Security Rule for protecting patient data, according to an April report from CynergisTek.
Investors have recognized the problem and are investing more into companies focused on the healthcare market specifically. MedCrypt’s competition for these security dollars include companies like Medigate, which raised $15 million earlier this year.
While Medigate focuses on network security, MedCrypt is focused on securing devices themselves. Both security functions are critical, according to investors.
“With regulators appropriately taking a hard look at medical device security and the sheer growth in the number of devices being added to already complex clinical networks,” there is a significant opportunity for companies tackling medical device security, according to a statement from Dr. Jonathan Root, who has led several IT-enabled healthcare investments for USVP.
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Mint founder Aaron Patzer launches Vital, an ER management tool that integrates with electronic health records
Aaron Patzer launched Mint to help consumers organize their finances. Now he’s raised $5.2 million from investors to launch Vital to bring that consumer-focused mindset to emergency rooms and hospitals to help them organize patient flow.
Patzer co-founded the company with his brother-in-law Justin Schrager, a doctor of emergency medicine at Emory University Hospital. The serial entrepreneur invested a million dollars and two years of peer-reviewed academic study and technical research and development to create Vital, according to a company statement.
Investors in the seed round include First Round Capital and DFJ, Bragiel Brothers, Meridian Street Capital, Refactor Capital and SV Angel. Alongside angel investors Vivek Garipalli, the chief executive of CloverHealth and Nat Turner and Zach Weinberg, the founders of Flatiron Health, these investors are hoping that Patzer can repeat in the healthcare industry the magic he brought to financial services.
“The HITECH* Act was well-intentioned, but now hospitals rely on outdated, slow, and inefficient software – and nowhere is it more painful than in the emergency room,” said Patzer, in a statement. “Doctors and nurses often put more time into paperwork and data entry than patient care. Vital uses smart, easy tech to reverse that, cutting wait times in half, reducing provider burnout and saving hospitals millions of dollars.”
Vital isn’t so much replacing the current system of electronic health records as providing a software integration layer that makes those systems easier to use, according to the company.
It’s basically a two-sided application with a survey for incoming patients. An admitting nurse begins the record and as a next step a patient receives a text to add details like height, weight, recent surgeries, medications and allergies, just as they would on a paper form. Patients can also submit a photo of themselves and their insurance card to expedite the process.
The information is then fed back into a tracking board that doctors and nurses use to prioritize care. A triage nurse then reviews the data and affirms that it is correct by taking vital signs and assessing patients.
All of that data is fed into an algorithm that analyzes the available information to predict a course of treatment and help staff in the emergency room prioritize who needs care first.
Vital’s selling the service to emergency rooms with a starting sticker price of $10,000 per month.
“Vital successfully built software with a modern, no-training-required interface, while also meeting HIPAA compliance. It’s what people expect from consumer software, but rarely see in healthcare,” says First Round investor Josh Kopelman, who’s taking a seat on the company’s board of directors. “Turning massive amounts of complex and regulated data into clean, easy products is what Mint.com did for money, and we’re proud to back a solution that’ll do the same in life and death situations.”
In some ways, Vital looks like the patient-facing admissions side of a coin that companies like Qventus have raised tens of millions of dollars to solve at the systems level.
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Acting as the data integrator between hospitals and digital health apps brings Redox $33 million
Investors have forked over $33 million in a new round of funding for Redox, hoping that the company can execute on its bid to serve as the link between healthcare providers and the technology companies bringing new digital services to market.
The financing comes just two months after Redox sealed a deal with Microsoft to act as the integration partner connecting Microsoft’s Teams product to electronic health records through the Fast Healthcare Interoperability Resources standard.
Redox sits at a critically important crossroads in the modern healthcare industry. Its founder, a former employee at the electronic health record software provider Epic, knows more than most about the central position that data occupies in U.S. healthcare at the moment.
“What we’re doing, we’re building the platform and connector to help health systems integrate with technologies in the cloud,” says chief executive, Luke Bonney.
Bonney served as a team lead in various divisions at Epic before launching Redox, and the Madison, Wis.-based company was crafted with the challenges other vendors faced when trying to integrate with legacy systems like the health record provider.
“The fundamental problem is helping a large health system use a third-party tool that they want to use,” says Bonney. And the biggest obstacle, he said, is finding a way to organize into a format that application developers can work with the data coming from healthcare providers.
Investors including RRE Ventures, Intermountain Ventures and .406 Ventures joined new investor Battery Ventures in financing the $33 million round. As part of the deal, Battery Ventures general partner Chelsea Stoner will take a seat on the company’s board.
Application developers pay for the number of integrations they have with a health system, and Redox enables them to connect through a standard application programming interface, according to the company.
Its approach allows secure messaging across any format associated with an organization’s electronic health record (EHR), the company said.
Redox works with more than 450 healthcare providers and hundreds of application developers, the company said.
High-profile healthcare networks that work with the company include AdventHealth, Atrium Health, Brigham & Women’s, Clarify Health, Cleveland Clinic, Geisinger, HCA, Healthgrades, Intermountain Healthcare, Invitae, Fitbit, Memorial Sloan Kettering, Microsoft, Ochsner, OSF HealthCare, PointClickCare, R1, ResMed, Stryker, UCSF, University of Pennsylvania and WellStar.
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Siilo injects $5.1M to try to transplant WhatsApp use in hospitals
Consumer messaging apps like WhatsApp are not only insanely popular for chatting with friends but have pushed deep into the workplace too, thanks to the speed and convenience they offer. They have even crept into hospitals, as time-strapped doctors reach for a quick and easy way to collaborate over patient cases on the ward.
Yet WhatsApp is not specifically designed with the safe sharing of highly sensitive medical information in mind. This is where Dutch startup Siilo has been carving a niche for itself for the past 2.5 years — via a free-at-the-point-of-use encrypted messaging app that’s intended for medical professions to securely collaborate on patient care, such as via in-app discussion groups and being able to securely store and share patient notes.
A business goal that could be buoyed by tighter EU regulations around handling personal data, say if hospital managers decide they need to address compliance risks around staff use of consumer messaging apps.
The app’s WhatsApp-style messaging interface will be instantly familiar to any smartphone user. But Siilo bakes in additional features for its target healthcare professional users, such as keeping photos, videos and files sent via the app siloed in an encrypted vault that’s entirely separate from any personal media also stored on the device.
Messages sent via Siilo are also automatically deleted after 30 days unless the user specifies a particular message should be retained. And the app does not make automated back-ups of users’ conversations.
Other doctor-friendly features include the ability to blur images (for patient privacy purposes); augment images with arrows for emphasis; and export threaded conversations to electronic health records.
There’s also mandatory security for accessing the app — with a requirement for either a PIN-code, fingerprint or facial recognition biometric to be used. While a remote wipe functionality to nix any locally stored data is baked into Siilo in the event of a device being lost or stolen.
Like WhatsApp, Siilo also uses end-to-end encryption — though in its case it says this is based on the opensource NaCl library
It also specifies that user messaging data is stored encrypted on European ISO-27001 certified servers — and deleted “as soon as we can”.
It also says it’s “possible” for its encryption code to be open to review on request.
Another addition is a user vetting layer to manually verify the medical professional users of its app are who they say they are.
Siilo says every user gets vetted. Though not prior to being able to use the messaging functions. But users that have passed verification unlock greater functionality — such as being able to search among other (verified) users to find peers or specialists to expand their professional network. Siilo says verification status is displayed on profiles.
“At Siilo, we coin this phenomenon ‘network medicine’, which is in contrast to the current old-fashioned, siloed medicine,” says CEO and co-founder Joost Bruggeman in a statement. “The goal is to improve patient care overall, and patients have a network of doctors providing input into their treatment.”
While Bruggeman brings the all-important medical background to the startup, another co-founder, Onno Bakker, has been in the mobile messaging game for a long time — having been one of the entrepreneurs behind the veteran web and mobile messaging platform, eBuddy.
A third co-founder, CFO Arvind Rao, tells us Siilo transplanted eBuddy’s messaging dev team — couching this ported in-house expertise as an advantage over some of the smaller rivals also chasing the healthcare messaging opportunity.
It is also of course having to compete technically with the very well-resourced and smoothly operating WhatsApp behemoth.
“Our main competitor is always WhatsApp,” Rao tells TechCrunch. “Obviously there are also other players trying to move in this space. TigerText is the largest in the US. In the UK we come across local players like Hospify and Forward.
“A major difference we have very experienced in-house dev team… The experience of this team has helped to build a messenger that really can compete in usability with WhatsApp that is reflected in our rapid adoption and usage numbers.”
“Having worked in the trenches as a surgery resident, I’ve experienced the challenges that healthcare professionals face firsthand,” adds Bruggeman. “With Siilo, we’re connecting all healthcare professionals to make them more efficient, enable them to share patient information securely and continue learning and share their knowledge. The directory of vetted healthcare professionals helps ensure they’re successful teamplayers within a wider healthcare network that takes care of the same patient.”
Siilo launched its app in May 2016 and has since grown to ~100,000 users, with more than 7.5 million messages currently being processed monthly and 6,000+ clinical chat groups active monthly.
“We haven’t come across any other secure messenger for healthcare in Europe with these figures in the App Store/Google Play rankings and therefore believe we are the largest in Europe,” adds Rao. “We have multiple large institutions across Western-Europe where doctors are using Siilo.”
On the security front, as well flagging the ISO 27001 certification the company has gained, he notes that it obtained “the highest NHS IG Toolkit level 3” — aka the now replaced system for organizations to self-assess their compliance with the UK’s National Health Service’s information governance processes, claiming “we haven’t seen [that] with any other messaging company”.
Siilo’s toolkit assessment was finalized at the end of Febuary 2018, and is valid for a year — so will be up for re-assessment under the replacement system (which was introduced this April) in Q1 2019. (Rao confirms they will be doing this “new (re-)assessment” at the end of the year.)
As well as being in active use in European hospitals such as St. George’s Hospital, London, and Charité Berlin, Germany, Siilo says its app has had some organic adoption by medical pros further afield — including among smaller home healthcare teams in California, and “entire transplantation teams” from Astana, Kazakhstan.
It also cites British Medical Journal research that found that of the 98.9% of U.K. hospital clinicians who now have smartphones, around a third are using consumer messaging apps in the clinical workplace. Persuading those healthcare workers to ditch WhatsApp at work is Siilo’s mission and challenge.
The team has just announced a €4.5 million (~$5.1M) seed to help it get onto the radar of more doctors. The round is led by EQT Ventures, with participation from existing investors. It says it will be using the funding to scale up its user base across Europe, with a particular focus on the UK and Germany.
Commenting on the funding in a statement, EQT Ventures’ Ashley Lundström, a venture lead and investment advisor at the VC firm, said: “The team was impressed with Siilo’s vision of creating a secure global network of healthcare professionals and the organic traction it has already achieved thanks to the team’s focus on building a product that’s easy to use. The healthcare industry has long been stuck using jurassic technologies and Siilo’s realtime messaging app can significantly improve efficiency
and patient care without putting patients’ data at risk.”
While the messaging app itself is free for healthcare professions to use, Siilo also offers a subscription service to monetize the freemium product.
This service, called Siilo Connect offers organisations and professional associations what it bills as “extensive management, administration, networking and software integration tools”, or just data regulation compliance services if they want the basic flavor of the paid tier.
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