StartUp Health Magazine Issue 10 by StartUp Health

Special Edition

MEET OUR NEW HEALTH TRANSFORMERS 31 founders tackle the greatest health challenges of our time

Join us in the StartUp Health Pavilion

IMPACT PLAYERS

A growing team of industry heavyweights embrace health moonshots

KP Yelpaala casts a bright vision for StartUp Health's new Health Equity Moonshot

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FOUNDERS’ LETTER

Diversity is the Way

First-principles thinking – the idea of breaking down complicated problems into basic elements so you can build back better from the ground up – is core to our strategic process at StartUp Health. It’s one of the best ways to unlock creative possibilities that shift us from linear to exponential progress. A decade after launching our plan for achieving health moonshots and our mission to improve the health and wellbeing of everyone in the world, we continue to examine our plan and the core principles that drive our thesis to identify what’s working and what’s not so we can recalibrate for the future. A first-principle that has always been foundational to us is that collaboration is key to achieving any health moonshot. Breaking down silos and leveraging the power of network effects is essential to exponential innovation in the vast and complicated world of healthcare. But what’s the unifying principle that ties all health moonshots together and makes collaboration work? How do we create global solutions that deliver on the promise of access to quality care for all, no matter who you are, where you live, or how much money you have? WE BELIEVE THE ANSWER IS DIVERSITY

Simply put, if we are going to make transformative progress in solving the great health challenges of our time, in the name of greater health for all, then the only answer that makes sense to us is to infuse new frameworks of health equity into the fabric of the health moonshots we are working to achieve. We need more diversity in thinking, a deeper understanding of the problems we are trying to solve, and networks that extend far beyond the closed loops and processes that currently dominate the market. This means we must dramatically accelerate the number of innovators focusing on solving health challenges with the lens of health equity in mind. And this means we must inspire, educate, and invest in exponentially more founders from historically marginalized backgrounds. To speed up progress, we need more founders who are women, more founders representing people of all races and backgrounds, and more diverse investors, boards, and advisors; and we need to unite as an ecosystem so that together we can build and scale transformative solutions for the world far beyond what anyone has created so far.

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"...If we are going to make transformative progress in solving the great health challenges of our time, in the name of greater health for all, then the only answer that makes sense to us is to infuse new frameworks of health equity into the fabric of all of the health moonshots we are working to achieve."

HEALTH EQUITY AS A FOUNDATIONAL LAYER FOR HEALTH MOONSHOTS

At StartUp Health, we have always backed founders from a diverse array of backgrounds and spanning 29 countries to date and we are proud that health equity has always been infused into our mission of transforming global health. We've done so because it's the right thing to do, and because it's good for business. According to research, teams with greater diversity have higher revenue, better margins and higher quality patient care. Yet, with global health outcomes getting worse, not better, it’s too clear that way more progress is needed. Which is why in September, we announced StartUp Health’s Health Equity Moonshot, at the Clinton Global Initiative specifically to reshape our health system and innovation ecosystem to be more fair and just in the name of greater health for all. What’s different about this health moonshot, which is being led by KP Yelpaala, a long-time Health Transformer in StartUp Health, is that we are designing its frameworks holistically into the fabric of all of our health moonshots from the ground up. We are looking backwards and forwards so that we can be intentional, long-term in our approach, and provide 360-degree support for underrepresented founders and patients around the world. This is a way of thinking for us that will last a lifetime and impact everything we do as a company. P.S. Want to be a part of our Health Equity Moonshot? Email us at healthequity@startuphealth.com

Steven Krein CEO, Co-founder & Managing Partner

Unity Stoakes President, Co-founder & Managing Partner

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EDITOR’S LETTER

The Soul of Innovation

How much is in a heap? A handful? A mound? You might not find yourself asking this question very often, but it’s an old philosophical quandary called the Sorites – or Heap – Paradox, used to highlight the pitfalls of vague language. In this issue, we’re proud to announce the launch of a Health Equity Moonshot, a new framework for how StartUp Health will inspire, educate, and invest in health entrepreneurs around the world. As someone tasked with writing on the subject, I'm very aware that the words "health equity" can mean different things to different people. Organizations like the CDC and the AMA have written helpful definitions, circling around a person’s ability to “attain their full health potential.” But how does that apply to our global community of startups? What we know is that for us, healthy equity means backing more founders from traditionally underrepresented communities, and more companies addressing the needs of marginalized populations. It also means acknowledging the social context in which our entrepreneurs live and work. How our health equity framework will be fleshed out will vary widely across our portfolio, and that variety is on display in these pages. Whether it's Adonica Shaw's communitydriven approach to women's health (meet Wingwomen on page 16), or Avanlee Christine's unique combo of senior care and grocery delivery (read about Avanlee Care on page 39), each startup presents equity scenarios and questions that have to be worked out with intentionality and openness. Back to that "heap." While language is incredibly important, we're not here just to define "health equity," or create a checklist that proves that a startup is playing by a set of rules. Rather, operationalizing health equity principles is about refocusing our global army of Health Transformers around a paradigm of care. It is about acknowledging the lived experiences of underrepresented founders who often feel unseen and unheard. And it's about love. Love of the other, of neighbor, of anyone who has been neglected, hurt or forgotten. With love as the soul of innovation, we can shift outward, from rules to opportunity, from scarcity to abundance. And then, together, we can transform health for everyone.

Logan Plaster Editor-in-Chief

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“StartUp Health gave us a 'blue check'..." ...and now we have investors who are wellknown leaders within the industry.”

-Sheena D. Franklin CEO & Founder K'ept Health

Entrepreneurs, learn how you can join StartUp Health at startuphealth.com

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Letters

Founders' Letter Editor's Letter

Bloomberg recognizes Cityblock Health, helmed by CEO & co-founder Toyin Ajayi, MD, as one of the only Black-led companies to reach unicorn status.

Health Transformer News 8

Comparably.com names Brian Neman, CEO & founder of Sanguine Biosciences on their lists of Best CEOs for Women, and for Best CEOs for Diversity.

Meet the Newest Health Transformers Wingwomen Simulatory MoodSpark Modern Ritual Mother Of Fact Avanlee Care Brainscanology JetSweat

TMA Precision Health FITTLE Precision Health Reports Augmental Technologies Glo Athelo Health Quickr Hav.

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Clockwise from top left: Modern Ritual is a family affair, Adonica Shaw launches WingWomen; KP Yelpaala helms the Health Equity Moonshot; Quickr's avatar-driven patient portal.

Features

Transforming Health For Everyone: Startup Health Launches Health Equity Moonshot Growing The Team: Startup Health Expands To Scale Impact

Health Moonshot Snapshots

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EDITOR-IN-CHIEF Logan Plaster DEPUTY EDITOR Jennifer Hankin

CONTRIBUTING EDITORS Nicole Kinsey, Rachel Freeman Lauren Schafer, Holly Zoeller startuphealth.com 7

35 recent portfolio company headlines

For daily health moonshot news, follow StartUp Health on Twitter @startuphealth and subscribe to the StartUp Health Insider newsletter startuphealth.com/ insider

Biome's Next-Generation Cardiovascular Performance Solution at Work CEDARS-SINAI MEDICAL CENTER 4/18/22

33 ways companies are improving the world of wellness: Quit Genius FAST COMPANY 5/3/22

PayGround Has Been in Business Less Than 4 Years, But They’re Still Making a World-Changing Impact FAST COMPANY 5/3/22

In Praise of Anxiety, by Tracy Dennis-Tiwary, PhD, Wise Therapeutics WALL STREET JOURNAL 5/6/22

Sen-Jam Initiates Subject Enrollment in Phase II COVID-19 Treatment Trial CLINICAL TRIALS ARENA 5/9/22

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The Wireless Arthroscopic Era Begins: Arthroscopy’s Evolution From the Incandescent Era to the Fiber-Optic Era to the Lazurite ArthroFree Wireless Era

JOURNAL OF ORTHOPAEDIC EXPERIENCE & INNOVATION 5/10/22

Virta Health is a 2021 Inc. Best Workplaces Honoree INC. 5/15/22

CNBC Disruptor 50: Virta Health / Cityblock Health CNBC 5/17/22

The Able Channel Wins Four 2022 Telly Awards THE TELLY AWARDS 5/31/22

MygenoMD, One Stop Wellness, PreventScripts, & Valhalla Healthcare Selected for Jumpstart Foundry's First Cohort of 2022 JUMPSTART FOUNDRY 6/7/22

De Oro Devices' NexStride Gadget That Helps People with Parkinson’s Fight ‘Freezing’ Attracts $2.8M TECHCRUNCH 6/8/22

Singaporean Medtech Us2.ai Gets CE Mark for Automated Cardiac Ultrasound Software MOBIHEALTHNEWS 6/9/22

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HEALTH TRANSFORMER AT A GLANCE NEWS /

Joseph Schneier of Trusty. care: Healthcare Can Be Affordable for Everyone NASDAQ 6/27/22

Data exchange platform Particle Health scores $25M -MOBIHEALTHNEWS

Cala Health Tackles Hand Tremors With Bioelectronic Treatment FORBES 6/10/22

Wisdom From the CEO of Vous Vitamins: Are Personalized Vitamins the Future of Wellness? MCKINSEY & COMPANY 6/22/22

Dr. Beth Goldstein of Modern Ritual and Other Dermatologists Warn About TikTok's Dangerous Skin Care Lies HUFFPOST 7/1/22

Meet Hucu.ai, a Startup That’s Like ‘Slack for Healthcare’ CRAIN'S CHICAGO BUSINESS 7/7/22

$9M RAISED Milwaukee Data Science Company Sift Healthcare Raises $9 Million

BIZTIMES - MILWAUKEE BUSINESS NEWS 7/15/22

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Clockwise from top: BrightPay, Yumlish and One Stop Wellness selected for MassChallenge U.S. EarlyStage 2022 Cohort

At Cala Health, Renee Ryan is Taking Wearable Devices into a New Era

Cityblock Health’s CMO Named to Business Insider’s List of CMOs to Watch

BrightPay, One Stop Wellness & Yumlish Selected for MassChallenge U.S. Early-Stage 2022 Cohort

Mammha and MedHaul Selected as HHS Equity in Postpartum Care Phase 1 Winners

SAN FRANCISCO BUSINESS TIMES 7/15/22

FIERCEHEALTHCARE 7/15/22

BUSINESS INSIDER 7/25/22

OFFICE ON WOMEN'S HEALTH 7/26/22

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HEALTH TRANSFORMER AT A GLANCE NEWS /

New Mayo Clinic Program Helps New AI Startup cliexa Get Market Ready MED CITY NEWS 7/27/22

Cyclica Is One of the Biotech Startups That Are Set to Take Off in the Next 12 Months, According to Top VCs

Hospital Buzz: LCMC Health Partnership with Babyscripts Provides Remote Monitoring Services for Women with High-Risk Pregnancies NEW ORLEANS MAGAZINE 8/1/22

BUSINESS INSIDER 7/28/22

Neolth App Helps Teenage Students Look After Their Mental Health WORLD ECONOMIC FORUM 7/28/22

Epicured Is Among the Best Gluten-Free Meal Delivery Services of 2022 HEALTHLINE 7/29/22

2022 Best Small Workplaces: Sanguine Biosciences FORTUNE 8/1/22

Policy Changes Are Needed to Further Reduce Perioperative Opioid Use, by Brand Newland, PharmD, CEO & Co-founder of Goldfinch Health THE AMERICAN JOURNAL OF MANAGED CARE 8/8/22

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NeuroSync's Brain-Testing VR Tech Goes International with European Approval FIERCE BIOTECH 8/1/22

Inc 5000 Honorees: Arrive Health, PatientWing, Quick'rCare, Sanguine Biosciences, & Mouthwath INC. 8/15/22

Unpluq Locks Your Phone Distractions So You Can Get Shiz Done TECHCRUNCH 8/23/22

Cityblock Health Is One of the Few Black-led Companies to Reach Unicorn Status BLOOMBERG 8/24/22

$10.5M RAISED More Early-Stage Startups Like Salvo Health Are Raising "Supergiant" SeedFunding Rounds Over $10M Than Ever. Here's Why. BUSINESS INSIDER 8/29/22

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Each issue we introduce you to the inspiring founders we invested in recently. Their work addresses a range of health moonshots, from Ending Cancer to Brain Health. Learn how you can back Health Transformers at healthmoonshots.com

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WINGWOMEN SIMULATORY MOODSPARK MODERN RITUAL MOTHER OF FACT AVANLEE CARE BRAINSCANOLOGY JETSWEAT TMA PRECISION HEALTH FITTLE PRECISION HEALTH REPORTS AUGMENTAL TECHNOLOGIES GLO ATHELO QUICKR HAV.

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HEALTH TRANSFORMER Adonica Shaw, CEO & Co-founder wingwomen@startuphealth.com 16 StartUp Health Magazine / TRANSFORMING HEALTH FOR EVERYONE

MEET THE HEALTH TRANSFORMERS

Wingwomen Is Building an Evidence-Backed Community Platform for Women Facing Reproductive Health Challenges CEO and founder Adonica Shaw is building on personal experience to create a secure social network for women’s health, giving women the peer support and clinical knowledge they need to thrive at every age.

WOMEN'S HEALTH MOONSHOT VINTAGE: 2022/Q2 MYWINGWOMEN.COM

Infertility. Miscarriage. Endometriosis. Cervical cancer. Uterine fibroids. The list of challenges a woman might face around her reproductive health goes on and on. Some of these difficulties are incredibly prevalent: about 10–15% of known pregnancies end in miscarriage; one in five women are unable to get pregnant after a year of trying; cervical cancer is the fourth most common cancer among women. Yet a woman walking through any one or several of these issues often finds herself alone. Her doctor can only give her 15 minutes of their time, and it can be hard to bring the topic up among friends and relatives. Even if she does bring it up, she

might receive trite responses that minimize her experience. “It will all work out. Just give it time.” Given the lack of coordinated care and support around reproductive health, it’s not surprising that many women turn to online forums on Facebook or Reddit to find advice or someone who can validate their feelings. These forums are both a rabbit hole and a minefield. Desperate for advice or support, women have to dig through pages and pages of questionable medical recommendations, personal stories that are different than their own, and arguments over types of treatments and tests, all the while exposing themselves by sharing highly personal medical information on the internet.

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MEET THE HEALTH TRANSFORMERS WINGWOMEN /

ORIGIN STORY

Adonica Shaw has been there. Five years ago when she was pregnant with her third child, she was diagnosed with preeclampsia, a condition marked by high blood pressure. Even though the condition disproportionately impacts women of color and Shaw was at a higher risk of developing it, no healthcare provider mentioned it until the moment she was diagnosed and told that they needed to immediately induce her delivery and get the baby out (the typical cure for the condition). Despite delivering, her condition worsened, and a few days after giving birth she experienced a code blue eclamptic crisis in the hospital. “When I left the hospital, I was coming down after a difficult diagnosis, birth trauma, a NICU baby that I hadn’t had a chance to bond with,” says Shaw. “I was 31 years old and they said, ‘you’re good to go.’” There was no follow-up care, no help with how to process what she’d experienced. She felt a sense of guilt for how her body responded to the pregnancy and struggled to grasp what happened to her. Her partner tried to empathize but couldn’t put himself in her shoes. “I found it difficult to talk about it all. What happens when you deviate from your health plan, your birth plan, your life plan?” Like many women before her, Shaw combed social media forums, looking for other women who’d gone through what she did. She brought it up to friends and family and eventually cobbled together a support system — a few women who

validated her experience and helped her understand and accept what she went through. With their help, she regained her sense of confidence and figured out a plan to take care of herself physically and emotionally after her traumatic health event. At the time, she was just trying to figure out how to move forward, but Shaw, a former Division 1 athlete, television anchor, and healthcare advocate, realized how many other women out there needed the same support. Not one to sit idly by when a problem presented itself, she got to work, and developed an online quiz and questionnaire designed to help women identify ways to practice self-care during health challenges. It was a small step towards a bigger idea: what does it look like, Shaw wondered, for women to get the support they need during difficult times? How could she make it easier for women to find the kind of network she struggled to put together after the birth of her child? She envisioned a digital platform where someone experiencing a reproductive health issue could find encouragement and advice from peers who have walked through the same thing, a place where personal health information could be shared safely through encryption. She wanted health recommendations that were vetted by experts but also a place a woman could come to vent about a bad experience with a healthcare provider or get tips on the best type of diet for infertility issues. She envisioned a place where women had each other’s back. To push this idea to the next level Shaw applied to and was accepted into MIT

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and Harvard Medical School’s Healthcare Innovation Program in 2021. Her cohort of doctors, researchers, and scientific communicators gave her a clearer lens on patient experience and how to design her platform to work in tandem with providers to follow best practices and encourage adherence to medications and recommendations. She listened as the doctors expressed frustration with their limited ability to address patient concerns in 15-minute appointment slots or how long it can take for a patient to accept a diagnosis and start effective treatment. Shaw realized during her time in the Innovation Program that what she was building — now called Wingwomen — was more than a social network or peer support. It was healthcare. UNDER THE HOOD

Wingwomen facilitates a digital environment for women to openly discuss issues relating to reproductive health, while keeping their data protected. When a woman joins the platform, she indicates areas of interests and can explore forums on different topics relevant to her concerns. After creating a profile, the user is in the driver’s seat and can chat, exchange contact info, post links and videos, or just observe the feed. To prevent misinformation and disinformation from spreading, the feed is monitored by certified healthcare professionals who make sure the content is grounded in science. Wingwomen is currently fundraising to build out its platform and piloting several programs that connect its users to

healthcare professionals and health coaching. One program they are beta testing is a health coaching program in which a user is referred by her physician at the point of diagnosis to a peer group led by a certified health coach with lived experience navigating reproductive health issues. Over the course of 12 weeks, the program covers everything from treatment adherence to understanding medications, to grief and loss and behavioral changes like nutrition and fitness. As they run these pilots, Wingwomen is working on data aggregation and visualization so that the platform provides highlevel data to healthcare professionals, actionable information that can help shape the future of women’s reproductive health. “There’s an opportunity here to help researchers identify areas in women’s health that have been neglected and need to be funded or to highlight different nuances,” says Shaw. For instance, Shaw intends for Wingwomen to shine a light on women’s mental health, particularly as it relates to reproductive health. Suicide and overdose are leading causes of death in the first year postpartum and there are clear links between infertility issues, endometriosis, and pregancy, and anxiety and depression. Yet physicians rarely screen their patients for these issues and it is a big leap for someone to seek psychological help, especially if this is their first time experiencing these feelings. “I see Wingwomen as a bridge, a place for pre-intervention to more serious health and psychiatric issues,” says Shaw.

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MEET THE HEALTH TRANSFORMERS WINGWOMEN /

“A place where someone can share and be vulnerable and come forward before something escalates.” Shaw also hopes for it to become commonplace and ordinary for young women to talk about their bodies and reproductive health. Wingwomen is partnering with several colleges in pilot programs to provide a forum for students’ concerns and questions, with moderation by healthcare providers to help them better understand their sexual health. The program normalizes terminology and empowers young women to openly engage in conversations about issues that might seem taboo. “Your body is the thing you have from your first breath until your last and it is the thing we talk the least about,” says Shaw. With Wingwomen working to lift these taboos around reproductive and mental health for women, that is primed for change. WHY WE’RE PROUD TO INVEST

At StartUp Health, we are always inspired by founders who face severe health challenges and then turn that experience into an idea that can help others. Adonica Shaw is a perfect example of this, having faced a traumatic pregnancy followed by a lack of community support during her recovery. She experienced the problem of the stigma and isolation that exists around women’s health, but she wasn’t satisfied solving the problem for herself alone. She knew that millions of women needed the same support. We’re proud to back Shaw as she leverages her experience and scales her impact.

But, as we often write, personal experience with a health challenge doesn’t a startup make. So we’re also excited to back Wingwomen because Shaw took the time to pressure test her concept at the MIT/ Harvard Medical School’s Healthcare Innovation Program. She did her own market research, surveying women and then brought the idea to clinicians and potential partners who can help her refine the business plan and eventually commercialize. She’s working with advocacy groups like MoMMA’s Voices and Preeclampsia Foundation to make sure she’s tied in with existing communities, not repeating what’s been done in the past. Finally, we’re passionate about supporting Shaw’s efforts at Wingwomen because there is a pressing global need to innovate in women’s health. It is 2022, and yet millions of women like Adonica Shaw still feel stigmatized about discussing reproductive health issues. Women, by and large, still aren’t getting the research-backed knowledge and care that they need. Female founders are still being told by investors that their concerns are niche when they actually affect hundreds of millions of people globally. The Women’s Health Moonshot — our global goal of raising healthcare quality for all women — needs an infusion of talent, ideas, products, and investment. With Wingowmen, Adonica Shaw is adding another important piece to fill out this puzzle, but we’re still just scratching the surface. 4 WINGWOMEN@STARTUPHEALTH.COM

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HEALTH TRANSFORMERS (L-R) Gayathri Venkat, COO & Co-founder Venkat Gourishankar, CEO & Co-founder simulatory@startuphealth.com

Puddle, Sumulatory's company mascot

Simulatory Is Upgrading Surgical Training with Customizable, Virtual Practice Simulations With their platform VRspine, cofounders Venkat Gourishankar and Gayathri Venkat are providing surgeons with the tools needed to practice complex procedures virtually, using advanced haptic feedback, with the goal of reducing complication rates.

ACCESS TO CARE MOONSHOT VINTAGE: 2022/Q2 THESIMULATORY.COM

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MEET THE HEALTH TRANSFORMERS SIMULATORY /

One of the most common types of spinal surgeries performed is a spinal fusion. During this procedure, a surgeon makes incisions along the stomach and back and fuses together two vertebrae in the spine, usually in order to repair a break. Needless to say it’s incredibly complex for the surgeon and just as hard on the patient, who has a recovery time of four to six weeks. That’s weeks of not being able to drive or even ride in a car, weeks of painful bowel movements, and weeks of struggling to complete basic tasks such as getting out of bed or walking down the stairs. And that’s a best-case recovery scenario. Then there are the 25% of patients who experience some kind of surgical complication post-op, for whom recovery can take anywhere from six weeks to six months. This complication rate and recovery time only increases for seniors. Spinal surgeries are just one of a myriad examples of traumatic invasive surgical procedures that are incredibly difficult to perform and painful to recover from. Not that surgeons aren’t up to the challenge; these are some of the brightest, best-trained physicians on the planet. The problem is that prepping for complex surgeries (spinal or otherwise) has historically been textbook based or performed on plastic simulation dummies. But these are both limiting, because not every patient is the same, and a text-book or dummy cannot always provide the patient-specific training a surgeon needs. Not to mention that simulation dummies are also very expensive and textbooks are constantly going out of date. What if spinal surgery didn’t have to be

so risky and the patient experience could be vastly improved? What if surgeons could practice a patient-specific surgery before having to operate, without the expense of a cumbersome simulation dummy? For Simulatory co-founders Venkat Gourishankar and Gayathri Venkat, the solution to these problems lies in reimagining surgical training. ORIGIN STORY

For decades, Venkat Gourishankar worked for the world’s top medical technology companies, like J&J and Stryker, developing haptic technology — the ability for software and hardware to convey the sense of touch to a user. He became an industry leader in the use of haptics in healthcare, and that expertise led him to the startup Simbionix, maker of surgical simulation tools. Then two things happened that set Gourishankar on a new path. Simbionix was acquired by 3D Systems and he met a woman named Gayathri Venkat. The acquisition acted as a spark, pushing Gourishankar beyond corporate R&D to think more creatively, more personally, about solving health challenges. For the first time he was able to ask, “What do I want to build? How do I want to improve health?” And then Venkat fanned the spark into a flame. Gayathri Venkat had worked in the medical technology space for 15 years, focusing on quality assurance and operations. Her passion was patient satisfaction and overall impact. “If there is a need, then there needs to be something to satisfy it,” says Venkat. “That’s the goal I work towards and that’s

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UNDER THE HOOD

my motivation.” When she met Gourishankar, the two began discussing new ideas for using haptics and virtual reality to improve surgical training and surgery outcomes. It quickly became clear that their skills were complementary, and because of their shared industry experience, they had the tools and networks available to test their hypotheses and move quickly on product ideas. The seeds of Simulatory were sewn. Gourishankar and Venkat launched Simulatory by leveraging their experience in robotics and surgical simulation in order to help surgeons train for ultra-minimally invasive surgical procedures. Their initial focus was on the most complex and risky surgeries, including spinal and brain procedures. They set about creating a device that would allow surgeons to input real patient data into a virtual reality simulator, in the hopes that better pre-op training would result in decreased recovery time and the post-op complication rate.

Simulatory’s roll-out device, VRspine, is a 100% virtual endoscopy simulator for surgeons and is what the founding team calls “the entry point to a spinal surgeon’s life.” Its overall design is aimed at being safe and efficient. The VRspine hardware closely models the latest minimally-invasive spinal endoscopy tools, such as an endoscopic camera and electrodes, in order to reduce the learning curve for surgeons. VRspine’s software displays realistic patient cases and human anatomy on a screen while the user operates the VRspine hardware, navigating through a virtual procedure. Haptic technology makes sure that the surgeon doesn’t just see the anatomy, but can feel it as well, learning by muscle memory as much as by sight. VRspine collects data during simulations to provide the user with performance metrics. These metrics can be analyzed by the surgeon to focus on areas of improvement. Artificial intelligence is used to increase and lower difficulty settings by learning the user’s movements and habits. “What we have come up with is a mock-mentor or mock-proctor,” says Venkat. “It basically guides you and it tells you where you are going wrong in the most obvious steps. This we did by mirroring the actual experts in the field.” Simulatory has taken these “experts in the field” and made them an integral part of their team. Currently, four specialists in neuro and spinal surgery sit on their Board of Advisors, providing medical advice and feedback.

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MEET THE HEALTH TRANSFORMERS SIMULATORY /

One of the most remarkable aspects of the VRspine is its ability to take into account specific patient data to create simulations for upcoming minimally-invasive surgeries that surgeons need to perform. “So, tomorrow if there is a surgery for a patient in spinal surgery, he can import the data today and go in and see what it really feels like,” says Venkat. VRspine’s virtual-first concept is more eco-friendly than its competitors, which use plastic to create training tools, while also being far more adaptable to new surgeries and techniques. “Tomorrow, let’s say Johnson and Johnson approaches and says that they want to do this for rhinoplasty,” says Venkat. “We can do this in a month’s time.” This is what makes Simulatory so unique and revolutionary. Where some might find a completely virtual training tool as limiting, Simulatory co-founders Venkat Gourishankar and Gayathri Venkat are using their expertise in haptics robotics to create an experience that is even more realistic than traditional simulators and more globally scalable. WHY WE’RE PROUD TO INVEST

These days StartUp Health invests in around 15 startups per quarter, so when it comes to founder stories, we’ve seen it all. Sometimes we’re drawn to founders who break type, who come from outside the traditional circles to completely rethink and disrupt a segment of healthcare delivery. We need these out-of-the-box thinkers. However, we also need industry insiders, the best-trained professionals in the

world, to innovate from within. That’s one reason we’re proud to back Venkat Gourishankar and Gayathri Venkat at Simulatory. Their experience in surgery simulation, haptics robotics, and healthcare operations is immense. They’ve worked on the mostadvanced products in the market, and this new venture stands on the shoulders of that work, rather than tearing it down to start over. In other words, this team has the experience to know exactly how to affect the market and have real patient impact. We’re also excited to back Gourishankar and Venkat because they have a dual focus on technology and access. It’s not enough to develop the next amazing simulation dummy or module if it costs a million dollars and only a handful of medical institutions around the world can afford to use it. Technology isn’t enough. The future of health lies in making the best of technology accessible to the world. By focusing on virtual-first simulations — powered by personal health data so they’re fully customizable — Simulatory takes a strong step in that direction. We’re proud to back this smart approach to improving global access to care. Finally, we’re proud to back the Simulatory team because their single-minded passion for improving patients’ lives is evident in everything they say and do. “If there’s one doctor who comes and tells me, ‘Your simulator helped me get through this surgery in 40 minutes,’ and the patient is amazing, that’s enough for me.” says Venkat. “That’s our goal.” 4 SIMULATORY@STARTUPHEALTH.COM

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MEET THE HEALTH TRANSFORMERS

MoodSpark Uses Audio Assistants and Reminiscence Therapy to Bring Comfort and Care to Isolated Seniors Eliot Arnold is a tech industry veteran who specializes in data-driven voice technology. While caring for his own aging father, he realized the potential for this technology to fight loneliness while also bringing relief to over-burdened caregivers.

HEALTH AGING & LONGEVITY MOONSHOT VINTAGE: 2022/Q2 GETMOODSPARK.COM

Within our Healthy Longevity & Aging Moonshot, there’s a numbers problem that overshadows almost every other challenge. We’ve written about it many times before, but it deserves repeating that

the world’s population of people older than 65 is exploding. In 2019, there were 54.1 million people in this age bracket and it is projected to reach 94.7 million by 2060. Seniors are also living longer, which means a dramatic increase in age-related health problems. The global increase in the population of seniors — and the fact that people are living longer on average — wouldn’t inherently be a problem if we had the tools and resources to respond. But there are two clear societal trends turning the aging startuphealth.com 25

MEET THE HEALTH TRANSFORMERS MOODSPARK /

world into a pending crisis. One challenge is that we live in an increasingly isolated society. Hyper-independent family units and remote work and lifestyle preferences have all conspired to create a world where elderly people are often out of sight and out of mind. Seniors might appreciate “aging in place” because they’re comfortable at home, but it also means they’re likely to be lonely, which has real health implications. Researchers have proven that social isolation and loneliness increase the risks of a range of health conditions, from heart disease to Alzheimer’s, even increasing the likelihood of death. Again, this paradigm would be manageable if we had a healthcare workforce trained and ready to care for the unique needs of seniors as they age. But we most definitely do not. There’s a workforce shortage — and rate of burnout — in the senior caregiver industry that is putting us on a true crisis course. We simply do not have the caregivers to handle today’s aging population, let alone tomorrow’s. Tech companies have begun to respond to senior isolation with an emphasis on audio assistants (think Alexa and Siri). But the complex needs of patients with Alzheimer’s and other neuro-degenerative diseases are more than consumer electronics can typically handle. To take one very simple example, someone with Alzheimer’s would have a very difficult time remembering that they had to say “Alexa!” to turn on their Amazon device. What if there was a purpose-built, always-on audio companion that could be there for seniors right when they needed it, alerting caregivers appropriately when

there’s a problem, and then delivering personalized therapy to fight loneliness? Enter Eliot Arnold, founder of MoodSpark. ORIGIN STORY

Eliot Arnold is a long-time tech entrepreneur who has specialized in automated, data-driven voice assistants. He sold his last company, a conversational interface for aiding data visualization, to Qlik, a Tableau competitor. But it was in 2017, when Hurricane Irma was bearing down on Florida, that Arnold got a glimpse of the greater potential of voice technology. It started with a phone call from his father’s caregiver saying that he needed to come quickly to get his dad to safety. “My father suffered from extreme anxiety which caused a lot of isolation in his life,” says Arnold. “His anxiety destroyed relationships which led to more anxiety.” That vicious cycle led to cognitive decline and a sedentary life, sometimes sitting in one place for 17 hours straight. Luckily, Arnold was able to get his father on the last flight out of Palm Beach before the hurricane hit. But the event made it painfully clear that his father’s isolation had led to serious health problems. “He went downhill really fast after that,” Arnold recalls. What was so eye-opening to Arnold wasn’t that his father was declining with age. It was how detrimental isolation had been to his health. He hadn’t had a stroke or a heart attack or even Type 2 diabetes. But he was isolated and anxious, and it became as deadly as a terminal disease. But then something happened that gave Ar-

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nold hope. “One night in one of my dad’s typical depressed or anxious states, I showed him a picture of the first sports card he’d ever earned as a young professional. His whole physiology changed. He became flush. He leaned in. He was reanimated. He began talking fluidly about the time the photo was taken. It triggered this emotional memory that was very physically therapeutic. In that moment, I knew there was something here.” Arnold’s initial hypothesis was that triggering long-term emotional memory recall could slow cognitive decline. He took that hypothesis to Dr. George Grossberg, the chief of geriatric psychiatry at St. Luke’s in St. Louis, Missouri. He was interested, but refocused the entrepreneur on an urgent downstream problem: helping caregivers manage moments of agitation, anxiety, or stress in the elderly. So Eliot Arnold got to work creating a team and a MoodSpark MVP. Early in the company’s life, Arnold acquired Dthera Sciences, which gave MoodSpark a wealth of relevant IP, patents, an FDA Breakthrough Device designation, and clinical pilot research related to treating anxiety, agitation, and depression in elderly patients. Dthera’s technology was similar to what Arnold was building, so the acquisition allowed the team to leapfrog forward and speed up their go-to-market strategy. UNDER THE HOOD

MoodSpark’s product currently consists of an audio companion that can be placed in a senior’s room and a platform utilized by their caregivers. The audio device re-

mains on at all times, so there’s no need to remember an “awake word” and it’s able to detect shifts in mood anytime, night or day, and elevate events to the care team as necessary. The first step, however, before the audio companion is switched on, is for the family of the patient to fill out a biographical profile. This is the personal outline that helps the platform — and the caregivers using it — respond to the patient in a contextual way. Next, the family uploads content from their life, such as photos, written documents, or social media feeds. This information forms the body of content that can be used during an intervention. Imagine that an 85-year-old man with Alzheimer’s is living in a skilled nursing facility. His family has built out a personal profile and uploaded photos from his early life serving in the Navy. One evening he begins to get agitated, raising his voice in anger. It’s common for people suffering from Alzheimer’s and other neuro-degenerative diseases to experience a period of agitation in the afternoon and evening, often referred to as “sundowning.” The MoodSpark device in the man’s room picks up the change in his mood through his tone and registers that he may be experiencing anger or agitation. That audio event is flagged and sent to a dedicated “tele-companion” on the MoodSpark platform. This caregiver assesses the validity of the event and, deeming it low risk, beams into the man’s room via a video visit. During this tele-consult call, the caregiver is able to bring up images and stories from the man’s file, prompting a moment of reminiscence that helps him relax and de-escalate. startuphealth.com 27

MEET THE HEALTH TRANSFORMERS MOODSPARK /

“We’re trying to serve two outcomes,” says Arnold. “We’re reducing social isolation and loneliness as well as addressing the need for an automated means of low-risk intervention in redirecting patients away from moments of anxiety. Highly personalized content is core to our therapeutic approach because we firmly believe that the human spirit can be cared for by sparking an emotional memory.” MoodSpark is able to notify caregivers of an episode by whatever means fits the moment, from text message to automated phone calls. They’ve created an escalation plan for when they detect distress. Today, MoodSpark is embarking on a pilot program at Delmar Gardens, a 500-bed skilled nursing facility, that is going to enable them to prove that they’re alleviating burden for caregivers. WHY WE’RE PROUD TO INVEST

Much has been written, and rightly so, about the vast and growing needs of the aging population. One reason we’re proud to back Eliot Arnold and the MoodSpark team is that they’re building a way to care for elderly patients while also caring for overburdened caregivers. We’re in the middle of a caregiver crisis and any senior care solution needs to recognize that there are two very human sides to this care equation. “If we meaningfully move the dial by shifting caregiver burden onto our platform and taking on some of those low-risk interventions, that’s a big win,” says Arnold. We’re also excited to back MoodSpark because Eliot Arnold has amassed a technical and clinical team that is at the forefront of audio assistants and geriatric psychiatry.

In addition to Arnold and his co-founder Martin Bukowski, MoodSpark has an advisory board that includes top physicians representing clinical psychiatry and palliative care. Finally, we’re excited to back Arnold and his team because they’re just scratching the surface on what’s possible in terms of audio assistants in healthcare and they’re well positioned to grow with the market. “We’re still in the early stages of voice assistant technology, which means there are ample opportunities, especially when it comes to nuanced, personalized interactions,” says Arnold. “When you combine biographical content with these conversational interfaces, you have this whole fascinating realm of communication and diagnostics. Plus, there’s a lot of tech available to us that will help detect how para-verbal sounds represent certain potential medical issues, like stroke or depression.” “I want support-assistive technology baked into the most familiar screens that seniors interface with on a daily basis. If that’s a television set, if it’s a phone, whatever. The component of synthetic companion care should be there in 10 years. We should not be as lonely as we are as people.” Rather than replace the human touch, MoodSpark uses technology to apply human-led care in more effective and scalable ways. That’s good news for aging seniors and the people who care for them, and it’s a mission we can wholeheartedly get behind. Join us in welcoming Eliot Arnold and the MoodSpark team to the StartUp Health portfolio. 4 MOODSPARK@STARTUPHEALTH.COM

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MEET THE HEALTH TRANSFORMERS

Modern Ritual’s Unique Spin on Tele-Dermatology Helps Patients Spot Skin Cancer Early Mother-daughter duo Dr. Beth Goldstein and Elianna Goldstein have teamed up to fill a critical gap in skin cancer care, empowering point-of-care providers with a smartphone-compatible imaging device to expand access to skin cancer screenings.

HEALTH TRANSFORMERS (L-R) END CANCER HEALTH MOONSHOT VINTAGE: 2022/Q2 GETMR.COM

Beth Goldstein, MD, CMO & Co-founder Elianna Goldstein, CEO & Co-founder modernritual@startuphealth.com startuphealth.com 29

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At first glance, the mom-ish figure who rotates between red- and green-framed reading glasses strikes you as an unlikely TikTok star. But as you watch Dr. Goldstein — aka @dermdrgoldstein — talk, you start to understand the appeal. In clear, matter-of-fact language, she uses TikTok videos to explain the alarming statistics about skin cancer, educating people on how to screen themselves and loved ones for concerning moles and spots, and dispelling common myths and misunderstandings. Beth Goldstein, MD, knows what she’s talking about. As a skin cancer surgeon for over 30 years, president of one of the largest practices in the Raleigh-Durham area, she’s watched as skin cancer rates have doubled. “I kept seeing more and more patients with skin cancer and it was clear that existing solutions weren’t working,” says Dr. Goldstein. Men in particular are less likely to use sun protection or have regular checkups with a dermatologist, which increases their chances of a negative outcome. It is estimated that by 2040, melanomas will be the number one cancer for men and second in women after breast cancer. These statistics highlight the importance of both prevention and early detection. Most skin cancers have a high cure rate when caught at the beginning stages. but it’s estimated that 40% of the US lacks enough dermatologists for their population. Appointment wait times can stretch to months, eliminating the window for timely intervention and having a huge

impact on both health outcomes and cost. This dynamic means that 95% of the $8B spent on skin cancer is due to late-stage detection rather than money going towards the early interventions that provide better outcomes. As Dr. Goldstein watched this play out over the years with her patients, she began to brainstorm ways to shift late-stage detection to earlier prevention and the type of vigilant self-monitoring that allowed people to notice changes to moles and spots. Then, in 2018, the true urgency of the challenge hit home. Her own husband (a family physician) was diagnosed with and treated for skin cancer. She knew she needed to bring her expertise to more people and empower them with tools that prevented more negative outcomes. ORIGIN STORY

As Dr. Goldstein was asking these questions, her daughter, Elianna Goldstein, was participating in Venture for America, a fellowship program that pairs aspiring entrepreneurs with startups and equips them with skills and resources to begin their own startup journey. After working in venture capital for two years, Elianna, inspired in part by her two doctor parents, knew she wanted to work in public health and improve access to care. Because of her mother’s expertise and her father’s diagnosis, she was also well aware of the statistics surrounding men and skin cancer and saw a chance to drive change on a large scale. “Skin cancer is growing rapidly, especially among men, and there are so few consumer-oriented products that target

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that population.” The mother and daughter envisioned a simple, all-in-one skincare product for men that provided dermatologist-backed sun protection and didn’t break the bank. The result? A daily, mineral sunscreen with anti-aging, moisturizing, and soothing ingredients that is lightweight and works well on men’s typically oily skin. They launched the product in 2020 as Get Mr., and immediately found an audience, with features on The Today Show, Katie Couric, and as one of Men’s Health Magazine’s top grooming award winners. They also noticed an interesting dynamic. They kept hearing the same thing from their customers, particularly women who purchased Get Mr. as a gift for a man in their life. “Thank you so much for this product,” they would write, adding, “Can I also send you a picture of the weird spot on my husband’s back?” The @dermdrgoldstein’s TikTok DMs overflowed with the same requests. They realized that there was a bigger gap in the market than pro-

Clockwise from top left: (1) Using dermascope to take images of patient's leg; (2) Teledermatology app allows providers to input patient information on the spot of concern; (3) Dr. Beth Goldstein and Elianna Goldstein shipping out their first face lotion after being featured on national television with Katie Couric.

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MEET THE HEALTH TRANSFORMERS MODERN RITUAL /

tective skin care products. People needed a fast, reliable way to get their spots evaluated by a certified dermatologist. The mother-daughter duo expanded their vision. How could they expand access to dermatologists to aid in skin cancer triaging? Could they catch these potential malignancies early enough to enable a favorable prognosis? Dr. Goldstein knew dermoscopes existed that took the type of quality imaging that allowed for remote diagnosis, but as of yet, there wasn’t widespread adoption of this technology outside of dermatology offices. Something needed to change for this to become routine, a normal ritual of skin monitoring. UNDER THE HOOD

Modern Ritual shifts the typical skin cancer screening process of months-long waits for an in-office dermatological appointment to a simple, point-of-care screening, with board-certified dermatologist and dermatopathologist recommendations for the user in one to two business days. They’re working with pharmacies, minute clinics, in-home caretakers, and even patients directly, to pave the way for detecting suspicious spots earlier. The company utilizes existing technology — smartphone-compatible dermoscopes — that take polarized images which provide a 90–95% degree of accuracy for diagnosis. Because these photos reveal more of the vascular structure underneath the skin, they actually allow greater accuracy than an in-office, naked eye reading which are 60–65% accurate. “Two big factors that made the time right for Modern Ritual is how COVID

rapidly changed people’s comfort with remote-monitoring solutions and how this type of scope enables dermatologists to make accurate diagnoses from an image,” says Elianna Goldstein. For point-of-care providers — anyone from a pharmacist to a homecare nurse to a PCP — Modern Ritual provides an easy-to-use service that allows them to expand their offerings, while improving their user’s experiences. For patients who are looking for an at-home check, and do not have a pointof-care provider near them, they are able to choose from two plans directly on Modern Ritual Health’s website. They can receive a rental scope for a one-time check of a set number of spots, or they can choose a membership option where they keep the scope over a longer period of time and have their spots reviewed periodically. The membership option particularly appeals to people in families with high rates of skin cancer who struggle to get the appointments they need. “People with a family history of skin cancer are anxious and hyper-focused on their skin,” Elianna explains. “I spoke to a woman in Maine who had a melanoma by the age of 30 and is regularly driving two hours to the nearest dermatologist, experiencing the anxiety of having to wait for an appointment when she could be screened from home.” Modern Ritual currently serves North Carolina, New York, Louisiana, Alabama, and Florida, with plans to expand to additional states in 2023.

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WHY WE’RE PROUD TO INVEST

Sometimes health innovation means cooking up something completely novel in the lab. But often it means finding new, creative ways to get the current standard of care to more people. In our Health Moonshot to End Cancer, we need both kinds of innovation. Skin cancer is a great example. It is a huge and growing problem, but we have tools and therapies that can save lives if we can just get them to the right patients at the right time. We’re proud to back Modern Ritual because they’re getting creative about preventative therapies as well as business models. The Goldsteins are utilizing time-tested technology but delivering it — and marketing it — in ways that haven’t been seen before. We’re excited to back Modern Ritual because they’re growing aggressively into new markets. The coming year will see them fundraise in order to scale up with providers and find partnerships that expand their audience. They’re interested in partnerings in the sports space and envision popups at outdoor events like NASCAR races. Their viral success on TikTok sets them up nicely to test out these new markets and see where growth is most likely. Modern Ritual is a health moonshot triple threat. They’re obviously tackling cancer and saving lives, and we’ve discussed how their business model is opening up access to care for people in regions that lack dermatology specialists. And they’re also reducing costs dramatically. The annual cost of treating new patients with melanoma is projected to triple in 10

years. The potential cost savings to insurance companies and payers for catching these skin cancers early is in the billions. “We believe that everyone deserves access to dermatology,” says Dr. Goldstein, and with simple tools and a clear patient path, she and the Modern Ritual team are well on their way to making it ordinary and easy to incorporate dermatological screenings and skin health routines into people’s lives — no matter where they are. Finally, we’re proud to back Dr. Beth Goldstein and Eliana Goldstein because in their close collaborative relationship we see the mindset of the Health Transformer. Elianna attributes the complementary relationship between herself and her mother as a core part of what makes Modern Ritual tick. She’s the big picture thinker who pushes them to envision large-scale impact while her mother is the seasoned practitioner and manager who makes sure what they’re doing works, and works well. “People trust my mother. It’s so important because they come to our site and it’s a new idea for them and there’s a lot of education we have to do. But they’ll have seen a video on TikTok from her and feel comfortable with her and with the product.” It isn’t always easy to work with family — Eliana and her mother preemptively hired a business coach and counselor to help them work through conflict — but their relationship embodies the close collaboration, communication, and longterm commitment necessary to effect major change in health. 4 MODERNRITUAL@STARTUPHEALTH.COM startuphealth.com 33

HEALTH TRANSFORMER Emily Sylvester, CEO & Founder motheroffact@startuphealth.com 34 StartUp Health Magazine / TRANSFORMING HEALTH FOR EVERYONE

MEET THE HEALTH TRANSFORMERS

Mother of Fact Gives Moms the Virtual Nutrition and Feeding Support They Need to Thrive as Their Baby Grows After working for years in hospitals helping moms struggling to feed their babies, Emily Sylvester decided to go upstream. With her new virtual care app, she’s bringing the best of infant feeding wisdom and maternal health to moms in the comfort of their homes, intervening earlier and creating a 24/7 culture of support. CHILDREN'S HEALTH MOONSHOT VINTAGE: 2022/Q2 NURTURETALK.COM

It’s 3 AM and a mother is desperately trying to get her newborn to nurse. She’s been home from the hospital less than two days following a difficult delivery and can’t get her baby to latch. The baby was premature and she vaguely remembers the hospital lactation consultant who stopped by her room for five minutes mentioning she might need to supplement the baby with formula. So she sends her partner to the kitchen to start preparing a bottle. But she doesn’t know how much formula is right and if it would be better to keep trying to breastfeed because everyone keeps telling her breast is best and the baby won’t stop crying long enough for her to think. She balances her

phone in one hand, the baby in the other, and hops onto some parenting blog, scrolling through the comments looking for advice. She’s inundated with often-contradictory information: if she uses a bottle, the baby will have nipple confusion; use this formula not that; nurse the baby on one side until the breast drains then switch to the other. No, switch back and forth every 15 minutes. By the time her partner returns with the bottle, she is in tears, with no idea what to do. Now imagine the mother has her own postpartum health concerns to address: perhaps she was preeclamptic and is still trying to get her blood pressure to come down. Or her blood sugar hasn’t returned to normal after her case of gestational

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MEET THE HEALTH TRANSFORMERS MOTHER OF FACT /

diabetes. Maybe she’s from a low-income household and has difficulty accessing a grocery store with healthy food options. With so many potential hurdles to optimal feeding of a baby and optimal nutritional health for a mother, it’s little wonder that 60% of moms in the US today don’t get to meet their baby feeding goals. It’s more than just a matter of thwarted goals, though. These feeding problems have far-reaching consequences that extend beyond the baby’s first year into both their overall health and wellbeing as well as the mother’s. It is currently estimated that 61% of US infant deaths can be prevented by increased access to nutrition care. Early nutritional deficits are also linked to long-term impairment in growth and health. Low rates of breastfeeding (the optimal diet for an infant’s first year of life) add more than $3B a year to medical costs for the mother and child in the United States. Infants who were breastfed have reduced risks of asthma, obesity, Type 1 diabetes, and sudden infant death syndrome (SIDS). The benefits extend to mothers as well — breastfeeding lowers a mother’s risk of high blood pressure, ovarian cancer, breast cancer, and Type 2 diabetes. ORIGIN STORY

When it comes to the nutritional wellbeing of moms and babies, Emily Sylvester knows what’s at stake. A registered dietitian, lactation consultant, and chair of the Massachusetts Breastfeeding Coalition, she spent years working with families at major hospitals and community centers. She became intimately aware of the myriad

“The hospital was sending families home with very little followup. When questions arose, these moms didn’t know who to ask, or had to wait until an appointment, which meant no one was giving her the advice she needed at the decision point.”

challenges facing her patients, especially the high-risk populations who were more likely to experience complications like gestational diabetes and preeclampsia, resulting in premature birth and other issues that contribute to feeding difficulties. Sylvester zeroed in on the main problem for the families she worked with: access to care, especially access at the moment the families needed help choosing what to do. “The hospital was sending families home with very little follow-up. When questions arose, these moms didn’t know who to ask, or had to wait until an appointment, which meant no one was giving her the advice she needed at the decision point.” Instead of working preventatively in these situations, walking through the pregnancy with the mom and taking care of her health while preparing her for what was to come, families came to Sylvester’s clinic too late, when the feeding difficulties were already entrenched and taking a toll on the health of the family. These were predictable problems with predictable outcomes, but no one provided the consistent

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support parents needed to navigate their nutritional needs during pregnancy and postpartum. Watching this scenario play out time and time again galvanized Sylvester to action. She knew that when babies struggled to eat, the whole family struggled. She was tired of waiting for them to hit a breaking point to come see someone like her at the outpatient health center. She wanted more for families, especially those with limited resources. Sylvester envisioned a simple mobile platform that provided moms quick and easy access to registered dietitians, a place that provided trusted advice to patients based on their specific circumstances. She wanted an app to provide help in real time, knowing that feeding decisions are often made under duress between appointments. She wanted parents to have a trusted place to turn to during those 3 AM feeding sessions. “Imagine if the connection to help could be made at the decision-making point. It would shift the entire feeding journey for that week,” says Sylvester. So, like any great entrepreneur, she dove in head first and built a simple app called NurtureTalk, which was later rebranded to Mother of Fact. At first, she was the sole clinician on the app, making herself available virtually to a pilot group of patients 24/7 to answer their questions. Then COVID-19 hit and her patients’ need for remote care skyrocketed. This initial group of 67 moms was able to receive timely evidence-based care from a licensed professional, all through their phones. This

first run of the program, funded through a research study, proved to Sylvester what she suspected: when families can access the right nutritional care when they need it, the whole family benefits. UNDER THE HOOD

Here’s how Mother of Fact’s infant feeding mobile concierge works. A new user creates a profile that includes their pregnancy history, their baby feeding goals, and then the baby’s medical and nutritional therapy history. The app walks with the mother through her entire care journey, from pregnancy through infanthood. She receives live telehealth consults with a registered dietitian (a “best feeding friend”), as well as video courses tailored to her needs and goals that match the timeline in her feeding journey. The app provides 24/7 nutrition assessment, diagnosis, education, and monitoring — meaning no more feeding decisions made under duress or without good information. “All the communication with the mom is made to be fun and confidence building,” says Sylvester. “We want families to feel comfortable asking the questions they need to ask. We build trust so that they can come to us in those hard moments.” Mother of Fact employs its own dietitians and lactation consultants, training them in both best practices as well as how to counsel and connect with their clients. Sylvester believes that patients deserve access to someone who is from their community and aims for diversity in her hiring to help patients form that trusted

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MEET THE HEALTH TRANSFORMERS MOTHER OF FACT /

relationship with their clinician. By combining a cadre of diverse, skilled clinicians with some automation based on common feeding questions and milestones, Mother of Fact is able to provide care at scale, driving down the prices and increasing accessibility. Mother of Fact plans to officially launch their iterated MVP late 2022 and is raising $1M in a pre-seed round to finish and validate their tech and scale the team to meet the needs of established partnerships. The app will be available directly to consumers through a monthly subscription fee or through community or clinical partners that take the cost burden off of the families. Sylvester and her team are in early conversations with hospital systems on how to onboard users during pregnancy so that these patients can prepare to meet their babies’ nutrition needs with confidence and competence. “We want all families to have access to down-to-earth, evidence-based, unbiased nutritional advice. Every baby is different — I learned that when I had three of my own — and people need a trusted, verified source to help make these feeding decisions.” WHY WE’RE PROUD TO INVEST

When we met Emily Sylvester at Mother of Fact, we were immediately drawn to her combination of domain expertise and mission. Sylvester has lived and breathed and studied the issues surrounding infant nutrition that she’s now building a product to address. We’re proud to back a founder who's already helped thousands of families

raise healthy babies and knows where the challenges and opportunities lay. But we’re also drawn to Mother of Fact because of its health moonshot of improving health and wellbeing for children and women. In our decade of tracking health innovation funding data, we’ve seen that our Children’s Health Moonshot and the Women’s Health Moonshot have been historically underfunded. We need more entrepreneurs passionate about these markets. We’re also excited to back Sylvestor and Mother of Fact because she’s gathered a stellar team around her that includes current CEOs, infant feeding experts, medical sales professionals, and marketing executives who have launched more than 10 products and founded six companies. Combined, Mother of Fact’s advisory team has achieved $500M of revenue and investments over the last decade. Finally, we’re proud to back Mother of Fact because it represents a critical step towards opening up access to care. Getting personalized advice about infant feeding or maternal nutrition shouldn’t be something that only the wealthy can afford or those who live near large hospitals. We have the technology at our fingertips to meet new moms where they’re at, bringing them high-quality, HIPAA-secure support right when they need it. By combining the best of automation with the personal touch of real healthcare providers, Mother of Fact can scale care to the communities that have been traditionally underserved. 4 MOTHEROFFACT@STARTUPHEALTH.COM

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Avanlee Care’s App-Based Tools Help Caregivers Take Care of Loved Ones, Wherever They Live Founder Avanlee Christine has combined her experience in nursing and health tech to build a “sticky” senior care app that also improves life for caregivers. The company’s recent partnership with Walmart even makes it possible for caregivers to order food for their loved ones within the app, at the click of a button.

HEALTH TRANSFORMER HEALTHY AGING & LONGEVITY MOONSHOT VINTAGE: 2022/Q2 AVANLEECARE.COM

Avanlee Christine, CEO & Founder (second from left) avanleecare@startuphealth.com startuphealth.com 39

MEET THE HEALTH TRANSFORMERS AVANLEE CARE/

Avanlee Christine was 10 years old when her grandfather became ill. She watched as her mother and aunts and grandmother took care of him for the next eight years before his passing. “I saw the heartache and the stress and strain of caring for someone. I saw the fractured communication — what medications did he take today? Is he ok? Did someone visit him? Who’s covering the cost of that?” Her family is not alone with this challenge. This scenario plays out time and time again for families in America, and across the world. With the population over the age of 65 about to experience exponential growth and no end in sight to the shortage of paid caregivers, this burden on families will only continue to grow, especially with aging in place as the preferred choice for many seniors. The big question in the longevity space is how can technology make care easier and better for our aging population? And how do you get the seniors to adopt and use it? All too often a family member will invest in some sort of technology, like an iPad, drop it off with their older relative and simply expect them to figure out how to use it on their own. Sometimes that tech burden falls on a paid caregiver in a senior living facility, but they’re already overworked. In the end, the iPad ends up collecting dust on the shelf. Christine saw this side of the equation when she was in nursing school in 2011, working at a long-term care facility.

“The residents didn’t even know what the app store was, let alone how to go there and download what their families wanted them to. And the staff was too overwhelmed to help.” Even back then as a college student, Christine realized it was necessary for the families to be the ones driving the adoption of technology, that it needed to work for the family caregivers and make their lives easier, so that they were incentivized to get their older relatives using it. At the time she didn’t know it, but Christine had stumbled upon what would become a central tenet of Avanlee Care: helping family caregivers care better. ORIGIN STORY

Fast forward to 2016 and Avanlee Christine was now working as the VP of Sales for a health tech company. She was invited to speak on a roundtable at the Mobile World Congress in Barcelona on how tech companies could create solutions for senior care. After the talk, she walked around the room taking in some of the various proposed solutions and talking to developers and CEOs about their ideas. “There were robots to dispense medication and chatbots to reduce loneliness. But I knew from my time caring for my grandfather and working in a nursing home that these would be incredibly difficult for the seniors to adopt. I kept asking people if any of them had spent any time caring for a senior or had ever taken the time to show them how to use an iPad or an app. The answer was always no.” On her flight home from Barcelona

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to New York City, Christine’s mind was racing. She knew the innovations she saw weren’t meeting the needs of families and were a bridge too far for most seniors to easily adopt. What would it look like, she wondered, to combine her personal knowledge of caregiving with what she now understood about the health tech world? What tools did a family truly need to feel connected to an older loved one’s day-to-day care? Through what turned out to be a fortuitously timed life moment, Christine encountered Esther Dyson just as she was narrowing in on her vision for what would become Avanlee Care. Dyson, a thought leader and influential angel investor in emerging technology, is well known in the healthcare space. When they met, Christine immediately launched into her

idea — an app that helped families manage care for their older loved ones — and Dyson responded with some hardwon advice. “She told me two things: the first is that there’s been a million and one people who’ve tried to make a caregiving app so she said, ‘what are you going to do that’s different?’ And then she told me to leave New York; that it was too expensive for me to get something off the ground here. She was right.” Christine took the advice and returned home to Bozeman, MT. She worked a day job for two years while planning the launch of Avanlee Care. In Montana she also met her co-founder and CTO Chris Monson, who brought a very different kind of energy to the endeavor. “Basically, he’s everything I’m not,”

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MEET THE HEALTH TRANSFORMERS AVANLEE CARE/

Christine says with a big laugh. “He’s wise, patient, and calm. The first time we met, he listened to me talk about what I wanted him to build for two hours straight. I told him I couldn’t pay him, but he could share the company with me. Two weeks later he agreed to do it, and in a year built what I think would normally take seven programmers to do.” The two co-founders launched the initial version of Avanlee Care in the spring of 2020. The basic platform provided families with care coordination, a medication adherence system, health and mood monitoring and alerts, and private family social activity: a way to chat together. Christine called Dyson and she was one of the first people to download the app. This time, Dyson summoned her back to New York. “She said it was time to get back here and raise money. It was such a whirlwind. COVID hit, we had a massive influx of new users. I threw all my clothes and books into my car and Esther [Dyson] let me live in an apartment she owned while I figured stuff out.” UNDER THE HOOD

What Christine figured out — the thing that makes Avanlee Care different — is that the platform needed to focus on the adult caregiver. It needed to work for them and make their life easier. The basics of the app — providing daily medication reminders, health status updates, the ability to add doctors notes using speech-to-text — all serve this function. But Christine knew it needed to do more. “I wanted it to be a centralized location

“I ordered groceries for my grandma last night and started crying. The ability to access food delivery and care for her from across the country really changes everything. She loves tracking the delivery and waiting at the door for it and knowing that it came from me.”

for all of a person’s care needs and I knew that if this was the place people also came to order groceries or medication for a loved one, the app would become so sticky and we would be different in the market.” The goal was for Avanlee Care to partner with a big organization, a behemoth, to become a platform for the family member to send their aging parent groceries and pharmacy items, besides providing all of its other care coordination features. But how was a small startup supposed to convince a big box retailer to work with them? In a series of fortunate events, one introduction led to another and Christine ended up on a call pitching to Walmart executives. As it turned out, three out of four of the people on the call were women who were currently caring for their aging mothers. A short time after that call, Avanlee Care received an Affiliate Agreement contract from Walmart. They will officially launch integrated grocery delivery from Walmart through the app this month, bringing them one huge step closer to

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their goal of becoming the go-to platform for family caregivers. As Christine explains, the Walmart integration impacts her personally. “I ordered groceries for my grandma last night and started crying. The ability to access food delivery and care for her from across the country really changes everything. She loves tracking the delivery and waiting at the door for it and knowing that it came from me.” WHY WE’RE PROUD TO INVEST

We spend a lot of time at StartUp Health talking about the world’s rapidly aging population and the role that technology can play in helping people thrive as they age. But just as significant as these upwardly climbing numbers is the fact that the vast majority of people — 90% of Americans over 65 — want to age in place. That puts a massive burden on the millions and millions of unpaid family caregivers around the world. We don’t just have an aging crisis, we have a caregiver crisis, so we are proud to back Avanlee Care, a company that’s addressing these two concerns in tandem. By putting caregivers at the center, Avanlee is tapping into both a massive market opportunity and positioning themselves for outsized personal impact. We’re also excited to invest in Avanlee Care because since day one they’ve partnered with tech visionary — and longtime StartUp Health investor — Esther Dyson. Few people understand the startup landscape, and what it takes to break out, like Dyson, who sits on the boards of 23andMe, Luxoft, and Meetup. More impor-

tantly, Dyson will help Avanlee Care double down on impact and stay focused on their ultimate health moonshot mission. Finally, we’re proud to back Avanlee Christine and her team because they’ve taken a big step towards crossing the entrepreneurial “valley of death.” Their recent partnership with Walmart — which makes it possible for caregivers to order food for their loved ones without leaving the app — has the potential to accelerate adoption and improve app stickiness, which is a hurdle for any young health startup. The fact that Walmart showed such early interest in Avanlee Care suggests that the retailer is making caregivers a priority, which could pave the way for future collaborations. The year ahead promises to be a big one for Avanlee Care. They brought on an experienced COO, Chris Steel, to help them grow, and have their sights set on integrating pharmacy capabilities into their app so that families can use it to order medications for their loved ones. We’re excited to see what they build next. 4 AVANLEECARE@STARTUPHEALTH.COM

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BrainScanology’s New Algorithm Could Objectively and Rapidly Detect Alzheimer’s and Other Brain Conditions Computational biologist David Nguyen, PhD, invented an algorithm that looks at MRI images of the brain in a new way, measuring shape instead of area and volume. Now he’s teamed up with collaborators Harini Kumar and Van Pham to deploy the breakthrough technology for the early detection and monitoring of a host of brain conditions, from ADHD to schizophrenia. BRAIN HEALTH MOONSHOT VINTAGE: 2022/Q2 BRAINSCANOLOGY.COM

HEALTH TRANSFORMERS (L-R) David Nyugen, PhD, CEO & Co-founder Harini Kumar, COO & Co-founder brainscanology@startuphealth.com

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It’s hard to go a week without seeing a headline about the mental health crisis we face today. Depression and anxiety are on the rise across nearly every demographic and millions of people struggle with complex mental illnesses like bipolar disorder, schizophrenia, and autism. Part of the crisis is a provider shortage; there just aren’t enough mental health professionals, especially in rural regions. Telemedicine companies have stepped up in an attempt to bridge this gap, and now companies like Valera, Hurdle, and Journey — among others — offer virtual therapy that greatly expands access to care. And yet, an upstream problem remains. Diagnosing psychiatric conditions takes way too long and is subject to a lot of human error. For schizophrenia, for instance, it can take six months of meetings, assessments, and waiting to finally get to a diagnosis. Diagnosing Alzheimer’s, too, is time consuming and subjective. And diagnosis is just step one. Then comes the arduous and sometimes painful process of medication titration. This involves testing drugs and doses to see what works best for the patient, which means even more meetings and assessments and waiting. That whole time the mental health condition is throwing the patient’s life into disarray. What if there was a faster, more accurate way to diagnose and assess mental health conditions? What if, instead of waiting months to see how your brain was responding to a new medication, you could wait a single day? What if you could quickly and easily get an annual assessment for Alzheimer’s because you know it runs in your family?

This is precisely what David Nguyen, PhD, and his team at BrainScanology are creating. With their novel algorithm that reads MRIs of the brain in a whole new way, they’re able to bring clarity to mental health diagnoses within 24 hours. They’re starting with Alzheimer’s disease, bipolar disorder, schizophrenia, autism, and ADHD, but their patented technology has broad and exciting potential. ORIGIN STORY

For David Nguyen, it can feel like all the pieces for his life and work, small and large, triumphant and tragic, have led to BrainScanology. As with many health innovators, the hardest parts of his story became his greatest inspiration. In grad school, while studying to become a computational biologist, Nguyen fell into such a depression that he had thoughts of ending his life. Thankfully he was able to find a therapist and get on a medication that worked for him, but it was a long and cumbersome process. One of David’s roommates and close friends at the time wasn’t as fortunate. He had bipolar disorder and struggled to get the professional help he needed. He ultimately died by suicide. At the friend’s funeral, David quietly committed himself to doing something about this problem of mental healthcare access, but he had no idea how his work in the lab could connect. Years later, Nguyen learned that his high school science teacher, a beloved instructor who’d inspired him to go into science, had died of colon cancer. It happened that Nguyen was working on tumor biology in his lab, and he fell into a fervor, dedicating himself day and night to studying colon polyps. He wanted to

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MEET THE HEALTH TRANSFORMERS BRAINSCANOLOGY / come up with something positive that would commemorate this man and the impact he’d had on his life. For several days he worked the problem, trying to look at it from new angles. Then suddenly something clicked. In his field there was a concept called the Fourier Transform that analyzes complex waves. But there was no way to apply that to two-dimensional shapes, like what a pathologist would look at with a colon polyp. Nguyen created a way to bridge that gap, and the LCPC transform was invented. What Nguyen invented — and what has become the cornerstone technology behind his company BrainScanology — is an algorithm that measures and analyzes complex shapes in an MRI, not just area and volume as has been the practice for decades. “We recognize squiggliness, but our brains cannot comprehend the significance of that squiggliness,” says Nguyen, trying his best to put the concept in layman’s terms. “Think about two strands of cooked spaghetti on a dinner plate. You know they’re both squiggly, but you can’t quantify it. Measuring area and volume aren’t going to help you. Their difference in squiggliness seems trivial until one shape means you’re going to die in six months.” Nguyen made his first debut with the algorithm at a hackathon at the QBI Institute of the University of California, San Francisco. There, he was able to show that by analyzing and measuring complex shapes and patterns on an MRI, he could successfully identify patients with ADHD. At that point, he knew he was

onto something important, something that would impact healthcare far beyond the brain. Nguyen teamed up with long-time collaborator Harini Kumar, a cognitive scientist with an MBA, raised enough capital to quit his day job, and BrainScanology was born. “I’m so excited to be working on a technology that’s going to revolutionize not only early diagnosis of psychiatric disorders but so many industries,” says Kumar. The two took a leap forward towards commercialization when they brought on Van Pham as CTO, a seasoned engineer from Venmo who specializes in building engineering teams and scaling operations. Van Pham was juggling many recruitment offers at the time, but chose upstart BrainScanology because he’d witnessed a family member deteriorate due to dementia. UNDER THE HOOD

In the ecosystem of health innovation, BrainScanology is unique in that it is truly an invention on a journey towards application. David Nguyen’s novel way to read MRIs — measuring shape instead of area and volume — has potential applications across a range of industries. The team is focusing first on a few high-impact mental health conditions, but that’s just the tip of the iceberg. Currently, Nguyen and his team are building ways to get their technology to market, train their algorithm (by feeding it lots of patient data), and create revenue so they can keep validating. One way they’re doing this is by offering a subscription service for brain assessments

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that can give any consumer an annual check for conditions like Alzheimer’s and ADHD. They’re focusing this product on the Latin American market, using online ads to reach consumers directly. They’ve seen strong interest with more than a million site visits a week. But the bigger play, once BrainScanology gets FDA clearance, is to offer an easyto-use platform for use by every healthcare institution and provider. From Kaiser Permanente to university health systems to individual employers, BrainScanology plans to offer the technology to quickly (within 24 hours) provide accurate and automated brain condition assessments. Not only will patients suffering from severe conditions be able to get treatment faster, but concerned patients will be able to receive regular check-ups and get a longitudinal picture of their brain health. BrainScanology’s platform architecture is being built to scale. Their ultimate goal is to create a secure and scalable multitenant SaaS platform available to the whole world. WHY WE’RE PROUD TO INVEST

To hear David Nguyen’s story is to become immediately inspired by the future he’s creating. He combined personal passion with decades of work in science and the result was a breakthrough that could shape healthcare diagnostics for years to come. But it all started with an innovator’s mindset. “My fundamental philosophy in science is to chase the unknown,” says Nguyen. “I take risks, but that’s where the fun of science is. I assume that if the field

hasn’t solved it for a long time, and they’re all smart, it means they’re looking at it the wrong way.” We’re also excited about Nguyen and his team because they’re building the kind of scalable platform infrastructure that could increase access to care globally. To date, mental health assessments have relied heavily on one-on-one interactions with providers. By default, these solutions gravitated towards the wealthiest regions, where those healthcare providers could be found. But this is a healthcare crisis that knows no boundaries. Millions of people around the world in low-resource settings need regular, reliable check-ups to assess brain health. BrainScanology’s approach to diagnostics also addresses a lack of tech infrastructure in many settings. “The latest imaging algorithms can’t help in low-resource settings because they depend on the latest imaging scanners (e.g. diffusion tensor imaging, PET scans),” says Nguyen. “BrainScanology’s algorithm, however, works even with images coming from old scanners that only provide structural information of organs.” Finally, we’re proud to back Nguyen and his team, who have chosen to think differently about seemingly intractable problems in mental health. They’ve gone upstream in an important way, moving from treatment to early detection, which will potentially help millions more people get the care they need. 4 BRAINSCANOLOGY@STARTUPHEALTH.COM

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MEET THE HEALTH TRANSFORMERS

JetSweat, the Turnkey Solution Helping Fitness Studios Scale Virtually Co-founders Alexandra Dantzig and Erin Frankel launched their startup to solve a personal pain point: lack of access to a marketplace of highquality boutique fitness classes on the go. But along the way, they’ve built a platform that supports an entire ecosystem of fitness brands and they’ve lowered costs, increasing access to top-tier fitness instruction so more people can stay active and healthy. 48 StartUp Health Magazine / TRANSFORMING HEALTH FOR EVERYONE

NUTRITION & FITNESS MOONSHOT VINTAGE: 2022/Q2 JETSWEATFITNESS.COM

HEALTH TRANSFORMERS (L-R) Erin Frankel, CCO & Co-founder Alexandra Dantzig, CEO & Co-founder jetsweat@startuphealth.com startuphealth.com 49

MEET THE HEALTH TRANSFORMERS JETSWEAT /

The fitness industry is booming. Whether you’re into Peloton, Planet Fitness, ClassPass, or Curves, there’s a brand ready to serve your workout needs. According to one study, this industry is expected to grow 171% in the next five years. COVID-19 ushered in a new era of online fitness options, and that virtual workout market is expected to grow even faster, as much as 33% per year over the next few years. Ostensibly, it’s never been easier to access fitness training than it is today, and yet the numbers tell us there’s a chasm between resources and reality. In 2018, The Lancet Global Health reported that more than one in four adults worldwide leads a physically inactive life. That number jumps to 75% in some countries. This sedentary lifestyle leads to a host of predictable-but-deadly health outcomes like heart disease and Type 2 diabetes. It also puts a hefty financial strain on already resource-strapped health systems. In other words, getting communities active isn’t just a nice-to-have; it can have massive global health and financial implications. One resource for helping people stay active is the local, independent fitness studio. These are often small businesses that cater to a specific population and offer personalized, specialized group classes. Unlike massive national chains, these boutique environments offer consumers the chance to connect with instructors and brands with unique methodologies, building the kind of relationship over time that keeps them accountable to their health

goals, often seeing better results. But there are a couple of challenges that have kept small and medium-sized fitness studios from having their full impact. Namely, they’re expensive and geographically specific — the top classes are only available in large cities. Also, because of their relatively small size, many have struggled to make the leap to digital, which further limits their reach and impact. They simply lack the technical resources needed to compete against enterprise companies and digital giants. Alexandra Dantzig and Erin Frankel saw these challenges firsthand and knew that by building an online marketplace for boutique fitness brands, they could solve problems on both sides of the equation, helping companies transform to digital while opening up access for consumers. ORIGIN STORY

Alexandra Dantzig and Erin Frankel met while taking a barre class in New York City. Or was it yoga? Or a HIIT class? They can’t remember now because they’ve gone to so many classes together it’s become a blur. They were young executives — Dantzig in finance and Frankel in media — and these classes were their way of staying sharp physically and mentally. Then one day, their perspective changed. They were attending a friend’s wedding out of town and decided to squeeze in a workout at the hotel gym. They looked at each other, and then at the sad excuse for a workout facility, and they started to work the problem like entrepreneurs. Why, they wondered, was it so hard to get access to

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“Most people use Zoom, but we launched a two-way livestream service that is native to the JetSweat platform,” says Dantzig. “You can see and interact with your instructor. Instructors can use this feature to correct a participant’s form or to give someone a shout-out of encouragement."

top tier fitness classes while on the road? Brands like Peloton and Daily Burn were paving the way for virtual fitness, but what about the thousands of excellent small studios where people could connect with an instructor and their unique style and brand? Could a virtual platform for boutique fitness brands make their services more affordable and accessible? That conversation could have ended at the wedding, but when the two returned to New York, they decided to discuss it again over coffee. That day they realized that they had complementary skills that aligned uniquely with the challenge. Dantzig had worked in finance for 10 years and part of her job was building digital platforms for various brokerages that wanted to have a foreign exchange offering. For her part, Frankel had a background in video production, working first for CNN and then NY1. She then was an early employee at a marketplace startup that was acquired by Constant Contact. They had the skills to build a video-

based marketplace platform, and they knew the challenge inside and out, so they took the leap. In 2018, they beta launched JetSweat as an iOS app. Once they developed the mobile experience they expanded to the web platform in 2019, and after refining the multi-platform user experience in 2021 they launched their enterprise white label solution for studios. When asked about early inflection points when JetSweat began to take off, Frankel says, “It’s not about one moment. It’s about execution. It’s about solving a real pain point for real people.” For JetSweat, that process took around two years of signing studios, creating content, validating their ideas, and then doing it all over again. They started the business B2C, making it easier for consumers to find and take part in boutique fitness classes online. But they morphed into a B2B model, selling a turnkey suite of services to fitness brands, from online scheduling and payments to two-way live-streaming to personalization — so they can up their game and find new customers. UNDER THE HOOD

For the consumer, JetSweat is about personalization and access. When a user logs on, they’re guided through an intake form that captures a few health data points. Then they’re offered more than a dozen filters that help them get granular with their fitness goals. What body part do they want to work on today? What equipment do they have available? Do they have any physical limitations? As people use the

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MEET THE HEALTH TRANSFORMERS JETSWEAT /

platform, it tracks their progress in real time and shows dynamic calorie burn. The user’s health data and their personal goals drive a discovery engine that then introduces them to unique fitness brands on the JetSweat marketplace. Boutique fitness studios are as varied as clothing brands, and smart consumers like to be able to shop and compare and fall in love with their favorites. On the B2B side, JetSweat is a virtual fitness studio in a box. They offer all of the administrative support and tools necessary for a fitness business to upgrade their tech stack, improve the user experience, and scale virtually. One of JetSweat’s biggest value drivers is its high-quality video content, driven by Frankel and her team of videographers. They are able to deploy their team to create custom content for studios in a range of markets. And it’s not just filming a class

so the virtual consumer is watching from a distance. It’s content created specifically for home users. The video, shot in 4K with three to four cameras in the room, includes the instructor plus a couple of people doing the workout as proxies for the at-home participants, without any special equipment. They’ve produced more than a thousand of these videos, and 90% of the video content on JetSweat is produced inhouse, giving the site a consistent quality. Another key offering has been JetSweat’s recent rollout of a two-way interactive livestream interface. “Most people use Zoom, but we launched a two-way livestream service that is native to the JetSweat platform,” says Dantzig. “You can see and interact with your instructor. Instructors can use this feature to correct a participant’s form or to give someone a shout-out of encouragement. That helps with building com-

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munity, which then helps boutique fitness brands take their classes to the next level and compete against the Pelotons of the world.” Fitness brands can choose to be a part of the broader JetSweat community through its marketplace, which, for $20/ month, offers users a choice of 40 studio brands and 800 videos. Or they can white label the technology and create their own walled garden where consumers subscribe to a single branded experience built on JetSweat’s technology. WHY WE’RE PROUD TO INVEST

High-quality, personalized fitness classes used to be a high-dollar luxury that only the lucky few, living in big cities, could afford. At $20/month, JetSweat breaks this paradigm without sacrificing on quality, opening up the best fitness offerings to anyone with an internet connection. Boutique fitness brands aren’t a panacea for the world’s pandemic of inactivity, but they are a powerful tool in the toolbox, and we’re proud to back a startup that is scaling that tool for the benefit of all. We’re also excited to back Dantzig, Frankel, and their team because their marketplace approach is solving problems on both sides of the equation. Not only are they helping consumers stay healthy, they’re keeping fitness brands in the black. COVID-19 forced many in-person fitness classes to go online, and some small and medium-sized studios struggled to make the leap. Many shut their doors. JetSweat makes that upgrade easy, so great wellness brands can stay in business and keep focus-

ing on their clients. We’re proud to back JetSweat because they’re growing quickly and positioning themselves for scale. There are 30,000 users on the marketplace platform with 40 studio brands representing hundreds of studio locations from the United States to Australia. Their newly-launched enterprise white label platform has begun accepting studios and is ready for rapid acceleration this year. We’re excited to back this startup because their data-driven approach will create a virtuous cycle for health and wellbeing. As more users create more data around health goals and progress and preferences, it will power greater personalization, which will help consumers create healthy habits. Finally, Dantzig and Frankel could have taken an easier road, licensing content and using a third-party tech platform. But they wanted to build it from the ground up in order to offer a purpose-built experience. Their emphasis on quality has become a benefit for consumers and businesses on the platform, who enjoy the higher level of services. But it also serves the health of the startup itself, making it considerably more defensible in a crowded market. 4 JETSWEAT@STARTUPHEALTH.COM

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HEALTH TRANSFORMERS (L-R) Joshua Resnikoff, CEO & Co-founder Javier Romero, MD, Chief Medical Officer Martin Grasso, Co-founder tmaprecisionhealth@startuphealth.com 54 StartUp Health Magazine / TRANSFORMING HEALTH FOR EVERYONE

MEET THE HEALTH TRANSFORMERS

TMA Precision Health helps rare disease patients find personalized treatment options and empowers pharma with data to speed up research and clinical trials Joshua Resnikoff and his team are leveraging their experience with rare diseases to build a patient-centered company that provides free whole genome sequencing to patients while helping pharma companies create custom datasets to drive innovation and recruit the right patients for clinical trials.

DISEASE PREVENTION & CURES MOONSHOT VINTAGE: 2022/Q2 TMAPRECISIONHEALTH.COM

When you think about “rare diseases” you’re likely to think about a one-in-a-million scenario. But the word “rare” is misleading. According to the NIH, there are more than 7,000 rare diseases and when taken together, the community of people directly affected by them is greater than 300 million globally. One in 10 Americans suffer from a rare disease – equivalent to the 30 million patients afflicted with diabetes. Yet in spite of this huge need, less than 3% of rare diseases have a dedicated drug therapy. The core challenge here is that the same variables that make it hard

for rare disease patients to get treatments make it difficult for pharma companies to develop cures. The problems common to rare disease sufferers are many and layered. More than 80% of all rare diseases are monogenic, meaning there’s a single genetic variant causing all the trouble. But most insurance companies - if they agree to pay for genetic testing at all - only provide gene panels or whole exome sequencing, which miss the specific mutation most of the time. And even if the exact mutation is identified, finding physicians who understand the condition or have experience with treat-

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MEET THE HEALTH TRANSFORMERS TMA PRECISION/ HEALTH

ment options can be nearly impossible. This leaves many rare disease patients and their care teams responsible for doing their own research. They turn into medical sleuths, trolling the internet for months looking for anything they can find related to the condition. Ultimately, even when information is available online, it’s highly technical. This makes it almost impossible to know what treatment to pursue. The problem for researchers and pharmaceutical companies trying to develop drugs and treatments for rare diseases is a numbers game, and the numbers are rarely in these patients’ favor. To advance a new therapy or treatment, a pharmaceutical company has to have the right data to identify the right drug targets, and then locate and recruit enough of the right patient participants to field a clinical trial. And the right data to make the right drugs can not just be people with the right outward presentation (called the phenotype, like seizures) but a precise genetic match, called a genotype. Without the correct genotype match, an effective drug can’t be developed and the trial either won’t begin or will fail once it has. This problem is so acute that 26% of rare disease clinical trials fail just due to bad patient matching, or roughly $1.35B dollars of wasted money. Thankfully, there are a few health entrepreneurs rethinking the challenges of rare disease. The team at TMA Precision Health, after experiencing their own rare disease struggles, came together at Brigham and Women’s Hospital in Boston to address the problem from multiple angles, by improving access to diagnostics and care for patients and providers while also em-

powering pharmaceutical companies with the data to advance treatments faster. ORIGIN STORY

Every story of a patient with a rare disease is unique, and yet there are so many common threads. Lina Williamson (a TMA co-founder) was born in Medellin, Colombia, and has suffered since early childhood from inexplicable chronic pain. At first her doctors called it PTSD – she’d lived through a bombing related to the drug trade. Then, as she got older, her doctors blamed her pain on “women’s problems.” It wasn’t until she moved to the United States and began working at Harvard University that she got her genome sequenced and discovered she had EhlersDanlos syndrome, a rare disease caused by a genetic mutation that affects the joints, skin, and blood vessels in a variety of ways. But due to a lack of drug options, even with her diagnosis in hand there was little she could do to get meaningful therapy. At Harvard, Williamson learned that while she was now “rare”, her experience was anything but unique. She met Joshua Resnikoff, whose son had a rare disorder that caused him to have monthly high fevers. As a one year old his temperature would spike to 105 degrees and then stay there for three days. Like Williamson, Resnikoff was in search of answers, and shocked that he couldn’t find them, despite working as a scientist at Harvard Medical. These common experiences turned from frustration to inspiration in 2019 when Williamson went to a scientific conference about orphan drugs and met Matt Might. Might’s son was born with

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A whole genome-based diagnosis is the single most important piece of health information for rare disease patients, but the cost of whole genome sequencing is prohibitively expensive in most of the world. So TMA Precision Health is solving that problem, partnering with a sequencing companies to offer free whole genome sequencing and analysis to any rare disease patient, anywhere in the world.

an incredibly rare and disabling genetic disorder called NGLY1 Deficiency. The child was the first known case of this disorder, prompting Might, a computer science professor, to search for answers. To aid his search he built an early AI software for rapidly scanning medical literature and connecting data based on medical concepts. This platform was what Might was presenting on when Williamson was in the audience, and it lit a spark. Williamson realized she could use Might’s platform to find non-traditional treatments for her Ehlers-Danlos disease. Then she brought the idea back to Harvard and Resnikoff was able to use it to identify new therapy options for his son. “This is a huge thing! Why isn’t this out in the world?” Resnikoff recalls thinking. Might’s platform was built for academic purposes, but Resnikoff and his collaborators knew there was massive potential. Not only could they help patients get diagnosed and help doctors create care paths for rare diseases, but by building a database of global rare disease patient data, they could assist pharmaceutical companies in creating more effective treatments faster. With the collaboration of venture

development veterans Martin Grasso and Arthur Maxwell, Resnikoff and Williamson launched TMA Precision Health. UNDER THE HOOD

At its heart, the TMA Precision Health is focused on helping the patient, which they do by providing a free 30x whole genome sequence so patients - with their care team - can zero-in on the root cause of their disease. A whole genome-based diagnosis is the single most important piece of health information for rare disease patients, but the cost of whole genome sequencing is prohibitively expensive in most of the world. So TMA Precision Health is solving that problem, partnering with a sequencing companies to offer free whole genome sequencing and analysis to any rare disease patient, anywhere in the world. This data gets paired with the patient medical records in TMA’s deidentified database to create a comprehensive understanding of the patient’s health, and let’s the team build cohorts of similar patients from around the globe. To support patient care, the TMA platform condenses months of research into minutes of search engine time by synthesizing information from dozens of data-

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bases into a single point of access. The platform is built as a bridge to care, providing a patient-friendly portal that anyone can use – even the anxious parents of a small child with a rare disease. The TMA team built and iterated this platform over a couple of years in stealth, and then launched it in Colombia through Lina Williamson’s healthcare connections. What they discovered first was that patient health records there were mostly in PDF form. So they built an application that allows users to drop in PDF records and the system will automatically extract that health information and structure it into clinically-relevant data and display it visually. “This is really important when you’re a rare disease patient because you might be carrying around hundreds of pages of medical documents that your providers then have to comb through in order to help you.” says Resnikoff. “We can take hundreds of pages of documentation – in 71 languages – and within a few minutes, put that into a visual representation of your health history. Anyone can get up to speed on your health quickly.” With a diagnosis, the platform can tell you about disease definitions and any available standard of care. No genetically confirmed diagnosis yet? The platform picks up on clinically relevant keywords within the medical record and matches them to disease descriptions. It then takes that information and finds all of the ongoing relevant clinical trials. The platform can even match care paths with ICD-10 codes and HPO terms, so that patients and providers can understand how much a potential therapy will cost.

For identifying repurposed drugs, the platform pores over millions of scholarly articles on PubMed and draws relationships between subject matter. Users can query specific concepts, like, “What synthetics have been used to treat EhlersDanlos,” or “What are the gene mutations associated with fevers?” That data helps patients and their doctors connect the dots between symptoms and known therapies, and natural and repurposed drugs as potential treatments. The treating doctor can use this information to create a personalized care plan for the patient, and then connect with a global disease expert for doctor-to-doctor guidance. “When your disease doesn’t have a set treatment option, being able to do that research quickly becomes really, really important,” says Resnikoff.

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MEET THE HEALTH TRANSFORMERS

In the end it's a win-win-win: consenting patients and providers get the best possible diagnostic service and a superpowered search tool to create personalized rare disease care plans, and they get a place to store this information in the cloud and connect to disease experts. In turn, TMA uses its database of paired patient genomic and medical data to create custom datasets for biotech research and prequalify patients for clinical trials based on exact inclusion and exclusion criteria. Pharma customers can enrich their trial enrollment upfront, only paying for the patients that fit their specific needs. “There’s a saying in precision medicine that you need the right drug at the right time. We also know that to make those drugs you need the right data for the right research and the right patients for the right trial,” says Resnikoff. “We’re really proud to have created a solution that achieves both.” WHY WE’RE PROUD TO INVEST

For the better part of a decade StartUp Health has been investing in companies dedicated to moonshots that cure disease. It’s natural that the world’s biggest killers, like heart disease and Type 2 diabetes, would capture a lot of that attention, and funding. But as TMA Precision Health spotlights, rare diseases are anything but rare when taken together – 300M patients globally. We’re proud to back a team that’s speaking directly to the needs of that patient community. We’re excited to back Resnikoff and his collaborators fromHarvard because they’re the right team for the job. Not only

do they have professional experience that spans from science to commercialization to ventures, but they’ve lived the challenges of rare diseases. That shared experience pushes them to imbue their platform with empathy, so that frightened parents and suffering patients get the healthcare dignity they deserve. Finally, we’re excited to back TMA Precision Health because they understand the paradigm that sometimes in order to “do good” you have to “do well.” They’ve made their platform and services free for patients and providers to use, so patients around the world can get access to the healthcare they need. By tackling problems for patients, they can solve the trial enrollment challenges facing pharmaceutical companies at the same time. And by creating a profitable business that supports CROs and pharma, TMA Precision Health will be able to expand their offering globally and impact many more lives. Put another way, their smart business model enables them to scale their global impact where it's needed most. 4 TMAPRECISIONHEALTH@STARTUPHEALTH.COM

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HEALTH TRANSFORMERS (L-R) Izzy Holder, CEO & Co-founder Tony Adams, COO & Co-founder fittle@startuphealth.com 60 StartUp Health Magazine / TRANSFORMING HEALTH FOR EVERYONE

MEET THE HEALTH TRANSFORMERS

FITTLE Is Bringing Strength Training into the Home Using a Beautiful Bench and Adaptable App Co-founders Izzy Holder and Tony Adams were fed up with home fitness gear that was ugly, bulky, and boring. So they designed an attractive way to bring free weights into the home and paired them with a flexible app that can accommodate any fitness preferences and goals.

NUTRITION & FITNESS MOONSHOT VINTAGE: 2022/Q2 FITTLE.FIT

We’re in the midst of an athome fitness revolution. It began pre-COVID, but was put into overdrive when the pandemic shut down gyms and sent the world into lockdown. People raced to buy stationary bikes, treadmills, free weights — even jump ropes — in the hopes of creating a fitness oasis in their homes. Fitness companies rushed to offer their classes online and fitness influencers on social media went viral. At the same time, as a society, we became more keenly aware of the connection between our physical wellbeing and our mental health. Isolation forced everyone to face the harsh reality of a sedentary life and how it contributes to anxiety and depression. Suddenly, having fitness tools available at home wasn’t just a nice-to-have. It

was a life line. What we saw post-COVID was the beginning of the democratization of health and fitness, and it was incredibly promising. But it was also just version one, a spasm of solutions thrown at an enormous problem, and it unearthed a range of new challenges that innovative startups are now addressing. One challenge is that most of today’s at-home fitness hardware is bulky, ugly, and expensive. Stationary bikes and treadmills take up a lot of space, and unless your house is big enough to have a workout room, it is unlikely to match your decor. And that’s assuming you use them consistently. For many people these large devices fall into disuse and become glorified clothing racks. Today’s offerings have also lacked variety. If you spend thousands of dollars instartuphealth.com 61

MEET THE HEALTH TRANSFORMERS FITTLE /

vesting in a Peloton bike, for instance, the only thing you can do is ride. You can log your workouts, but only if they fit into the app’s specific biking regimen. What about the person who likes to mix in an outdoor run or a pick-up game of soccer on Saturday? Today’s tools typically offer one exercise, usually cardio. If you get bored? Too bad. What’s more, to date, no at-home fitness platform has offered a comprehensive, affordable solution for weight training, even though working with weights has been proven to build bone strength, reduce back pain, and even sharpen your mind. For co-founders Izzy Holder and Tony Adams, it was time to develop the next version of at-home fitness, something that offers greater variety, customization, and also looks sleek and minimal in smaller homes where space is a premium. ORIGIN STORY

Izzy Holder and Tony Adams met in business school in France after working in investment banking and private equity in London for many years. Self-described fitness fanatics, the two became friends while training for a Spartan Race with 60 of their business school classmates. “We worked very long hours, and getting out to the gym was my oasis, and key to maintaining my mental health,” says Adams. As they trained, they bonded over their frustrations of staying fit during the COVID-19 pandemic. They both enjoyed the freedom that came from working out at home, but chafed against the virtual offerings. YouTube was too random. Peloton was big, expensive, and a bit boring. Tread-

mills didn’t fit into their city apartments or offer enough variety. What they really wanted was to workout with free weights, but they were expensive to order and lacked the accountability of other fitness apps. They also wanted an app that could adapt to the rest of their fitness preferences, not pigeon-hole them into a single activity. When Holder and Adams mentioned this challenge to their business school classmates, they were met with resounding agreement. So they took the seed of an idea — a beautiful, customizable hardware-plus-software solution for at-home strength training — wrote out a business plan and entered it into a venture competition. Out of 120 startups they made it to the finals, which caught the attention of investors. That infusion of capital allowed the two to quit their jobs and launch their company, FITTLE, full time in January 2022. FITTLE’s first order of business was to design a beautiful and functional weight bench and accompanying software, so Holder and Adams partnered with Mettle, an award-winning product design studio in London. “It’s rare to find a firm that nails hardware and software,” says Adams. Working with Mettle allowed FITTLE to expedite their development phase without building out a costly tech team. As such, they were able to develop prototypes in mere months. Now, they’re prepping for a preorder launch in September 2022. The next phase will be to build a community of about 100 power users and start learning in real time how people interact with the product.

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FITTLE is starting in the UK, with an eye towards urban residents, but that’s just the beginning. After expanding in Europe, the goal is to move across the Atlantic into the US market. UNDER THE HOOD

At a glance, FITTLE is an elegantly simple product. It looks like a beautiful bench that you’d be proud to display at the end of a bed or next to a sofa in even the sleekest urban apartment. Pull back the lid and you’ll find all the weights and accompanying equipment needed for a full strength and conditioning workout. No computer chips or gimmicky tools, it’s just a great weight set inside an attractive bench. That’s step one. Step two is the software component. When a user opens up the FITTLE app, they’re taken through an extensive onboarding experience that’s designed to simulate having a personal trainer. The user is asked detailed questions about their goals, their experience level, their preferences.

And not just goals and preferences that pertain directly to the FITTLE bench. The idea is to be as customizable and modular as possible, so if a user says they enjoy long runs on Sundays, that’s going to impact the workout program they receive. The app takes that data and suggests an initial four-week program. As the user completes each workout for the week, they tick them off the list, and at the end of the four-weeks they’re put into a growth week. This is a bit of recovery time for muscle building, and a chance to try a different type of training to keep things interesting. After this recovery week, the app asks the user to re-assess their goals and they’re given a new four-week training plan. “We do it in this five-week repeated pattern in order to build habits, rather than just day by day suggesting a workout,” says Holder. “On YouTube there is an abundance of free content,” says Adams, “but it’s using buzzwords like six-week abs. So people go crazy for a few weeks and then they fall off the bandwagon.” “This is just the beginning of how we can customize workouts,” says Holder. “There is so much data coming back that you can integrate into a fitness routine. For instance, in the future, your wearable device might detect that you did an extra hard startuphealth.com 63

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run yesterday, so it will scale back today’s workout accordingly.” One of FITTLE’s key components will be the community that it fosters. When people join the app, they’ll be invited into communities based on where they live, their preferences, and their goals. They can then connect, encouraging one another and sharing tips. The next step, says Holder, will be to create actual meet-ups for an even more genuine connection. FITTLE’s first product is a weight set in a beautiful bench, but weights are just the entry point. They’re designing the bench with enough room to house additional modular “packs” in the future, from yoga to pilates to barre. “The bench will be everything you could possibly need to workout and recover,” says Adams. WHY WE’RE PROUD TO INVEST

It was exciting to see innovative fitness companies respond to COVID and help people stay healthy at home, but that was just the spark. We’re proud to back a startup that is taking this market to the next level, not just creating another fitness solution but building on the shoulders of companies like Peloton and Tonal. FITTLE is addressing the challenges that emerged in the last two years in savvy ways, making them truly a company of the moment, poised to reach a new generation of consumers. We’re also excited to back FITTLE because they’re pushing back against the often-toxic all-or-nothing culture that can exist around fitness. In the past, to engage in weight training, most people had to give up their mornings or evenings and

trek to the gym. You were either a gym person or you weren’t. You owned a Peloton or you didn’t. With FITTLE’s weight bench and adaptable app experience, people can quickly begin integrating weights into whatever activities they already love, whether that’s walks, bike rides, or sports. Furthermore, if they want to learn a new type of exercise without feeling judged or intimidated at the gym, they can do so from the comfort of their own homes. “Fitness looks different for different people,” says Adams. “FITTLE allows for a more holistic view of fitness, and makes it so that working out from home can yield similar results to the gym. It can become a part of your lifestyle rather than detract from it.” Finally, we’re proud to back FITTLE because their approach to manufacturing puts a premium on sustainability — an element they’ve seen missing in the industry at large. Before they created their first batch they toured factories in Vietnam to find the right partner. They’re using sustainable woods, and they’re manufacturing in small batches, based on direct consumer demand, in order to avoid waste. They’re also fighting waste by building products that last. “We deliberately decided to make our bench less tech-heavy. That means less reliance on computer chips,” says Adams. “We don’t want people to buy our product and then discover it’s obsolete two years later, upselling them to version 2.0.” In a world of planned obsolescence, that’s music to our ears. 4 FITTLE@STARTUPHEALTH.COM

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MEET THE HEALTH TRANSFORMERS

Precision Health Reports Helps Patients Quickly Assess Their Future Risk of Heart Attack, Stroke, and Diabetes By combining predictive biomarkers, risk analysis tools, and clinical workflow automation, co-founders Matthew Martin and Bill Cromwell, MD, have made it easy for doctors and their patients to predict an individual’s risk for Type 2 diabetes, metabolic syndrome, heart attack, or stroke. These reports guide shared decisionmaking about lifestyle changes that can increase years of healthy life. DISEASE PREVENTION & CURES MOONSHOT VINTAGE: 2022/Q2 PRECISIONHEALTHREPORTS.COM

HEALTH TRANSFORMERS Matthew Martin, CEO & Co-founder Bill Cromwell, MD, CMO & Co-founder precisionhealthreports@startuphealth.com

A 68-year-old man walks into an exam room to see his family doctor for a regular checkup. He’s active and healthyappearing, so both he and his doctor see this as a routine meeting. The physician checks the chart and then looks him over. He’s gained a little weight since the last appointment and his blood results show a slightly elevated cholesterol. It’s nothing off the charts, so the doctor shares some general health advice around diet and exercise. Twelve short minutes later the session is over and the patient is on his way. He goes back to his life, eating and exercising as he always has, waiting for his next check-up or a dramatic change in his health status. For this man, who represents millions of patients, things like heart disease, stroke, and Type 2 diabetes are foreign concepts. These are ailments that happen to other people or at least much later in life. What the man doesn’t know is that certain unmanaged risk factors, changes in his life-

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MEET THE HEALTH TRANSFORMERS PRECISION HEALTH / REPORTS

style and physiology have conspired against him. He’s now pre-diabetic and only a few years from having one of the 805k heart attacks suffered each year in the US. Family doctors do amazing work. They are the bedrock of preventative health and their patients inherently trust their advice. But the vast majority do not have the time to do a complete preventative health assessment on every patient. Thankfully, there are some shortcuts. The American College of Cardiology developed a common heart disease risk calculator and the Universities of Virginia and Florida designed a metabolic disease risk score. These are two examples of scoring systems that take into account a range of health parameters and spit out the odds that you’ll have a specific health event in the coming years. The problem is, taken individually, these scores are still a bit too broad to be useful to patients. Plus, overburdened family docs don’t have the time to cobble together risk profiles one patient at a time. Until now, a family doctor had two choices. The first was to use only these rudimentary risk scores and perhaps make gut-feel adjustments, as in our opening story. After all, time is limited, and the patient will likely benefit from a general schooling in exercise and diet. The result is vague, non-specific guidance and dubious follow-through. The second option is to gather a bunch of data and collect lab results then apply these various risk scores manually. But this is highly complex and multifactorial, layering the patient’s history and physical exam and labs in a nuanced way that also adjusts for the patient’s age, gender, ethnicity, and comorbidities. You’d

basically have to be an expert in running these risk assessments to incorporate them into a busy family practice schedule. This paradigm is primed for disruption. Co-founders Matthew Martin and Bill Cromwell, MD, are taking the best risk assessments for heart attack, stroke, and diabetes and turning them into a fact-based automated tool that delivers actionable health insights to patients and their doctors so they can live longer, healthier lives. ORIGIN STORY

Matt Martin was a healthcare services executive, having spent 11 years at TrialCard helping people gain access to prescription pharmaceuticals. Then one day something unexpected happened that changed his trajectory forever. He and his family took a routine trip to visit his in-laws in Arkansas. In the middle of their stay, after multiple normal days of walking and shopping, his seemingly healthy mother-in-law died of a heart attack. Her death came as a complete shock. Martin was reeling, wondering how it was possible that someone like his mother-inlaw — who walked regularly, ate a seemingly healthy diet, and looked healthy — could be at risk of a heart attack and not know it. One of Matt’s mentors at TrialCard, knowing what he had gone through, and the questions he was asking, introduced him to a man named Dr. Cromwell. “He told me he knew this doctor in Raleigh who had this solution for identifying individual risk for diabetes, heart attack and stroke early, when intervention is easier to accomplish often through dietary and lifestyle changes,” says Martin.

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Dr. Cromwell, as Martin learned, was a chemist by training who was obsessed with a simple yet profound question: what is causing people to die that could be avoided? That question led him to the field of lipidology, where he became one of the field’s earliest and most-recognized thought leaders. After more than thirty years of research and clinical practice, he mastered the art of early identification of preventable disease. His innovative methodology had merit, but he was just one doctor. Martin’s mentor thought that perhaps, if combined with Martin’s business development experience, they could take a good idea and scale it for greater impact with many clinical practices. “We had the first conversation and it was an immediate ‘Hell yes!’ from me,” says Martin. “Once I heard his approach to preventing people from dying of heart attacks and strokes, that resonated with me immediately. I didn’t want anyone to have to go through what our family experienced if they could avoid it.” Martin went all in with Dr. Cromwell to bring this new tool to market that could provide early disease detection to millions. Precision Health Reports was born. UNDER THE HOOD

When a primary care doctor wants to assess a patient’s future risk of heart disease, stroke, or diabetes using Precision Health Reports, they start by entering a bare minimum of patient data: name and email. The patient gets an email informing them that their doctor has ordered a Cardiometabolic Risk Assessment. The patient follows a secure link to take a short health history

survey. Next, they get connected to a local LabCorp for a blood draw. The lab results are layered onto the patient survey data and then run through a proprietary algorithm that utilizes several highly-predictive disease risk scores that are all rooted in the national and international guidelines designed to help doctors reduce cardiometabolic disease. Both the patient and the doctor receive an email saying that the finished Precision Health Report is available for review. It was important to Martin and his team that the patient was invited into the risk assessment early, along with the doctor, so that they could come into their next appointment ready to dig into the details together. “Docs are busy. If they only have 14 minutes per patient, we want that time to be used on the best information possible for the shared decision-making necessary for sustainable change,” says Martin. The patient receives a score of their likelihood of a heart attack within the next 10 years, as well as a lifetime risk. The 10year risk assessment is the Pooled Cohort Equation that is common in the industry. But that number is just the starting point. The report gets specific and highlights the patient’s individual risk-enhancing factors, like sleep apnea, other related diseases, noninvasive imaging results, and lifestyle. Precision Health Reports is careful not to tell the patient what to do, but they do identify their specific biomarker targets known to reduce disease risk. This also empowers the doctor to incorporate their risk assessment results into their overall care plan. These standards and risk scores have existed for years. What’s innovative is the startuphealth.com 67

MEET THE HEALTH TRANSFORMERS PRECISION HEALTH / REPORTS

integration of clinical history with biomarkers, which are then run through more than forty internationally-recognized risk factors in an automated way that enables the doctor to uniquely — and rapidly — evaluate each patient. “We’re shortening the workflow, but we’re also bringing together the most predictive data points to apply guidelines most effectively and in a more personalized way,” says Martin. “We call it operationalizing the guidelines. We’re putting it all in one place for the first time.” WHY WE’RE PROUD TO INVEST

In 2012, the New England Journal of Medicine published a piece titled: “From Sick Care to Health Care: Reengineering Prevention into the U.S. System.” Ever since, the concept of “sick care” has been a popular trope in American healthcare, this idea that the healthcare system really only cares about you if you are already ill, ignoring the myriad ways to prevent and delay illnesses from starting altogether. At StartUp Health, we launched our Longevity and Healthy Aging Moonshot because we recognize there’s a lot more to health than waiting around for diseases to crop up. We need to move upstream, understanding the behaviors that hold illness at bay. We’re proud to back Precision Health Reports because they’ve created an elegantly simple tool that helps family doctors and patients do just that. Rather than hyper-focusing on sickness, Precision Health Reports uses the most clinicallyvalidated tools available to give people a glimpse into the future, helping them extend their healthy years.

We’re also excited to back Matthew Martin and Dr. Bill Cromwell because they’re empowering patients. The tools aren't just available through your family physician; any individual who wants to take control of their health and know their future risks can log on, go through the assessment, get their labs done, and then read the report. They can then take that report to their doctor, or to a health coach, or just start taking steps towards health on their own. “We built this as a tool for clinicians, but then discovered a wider audience of people who wanted to know this information about their health,” says Martin, who envisions an affordable subscription model for regular assessments. “We don’t want to be a poke-and-hope kind of company. We want to check you out, follow up, and help people move their numbers in the right direction.” Identifying risk early is huge. But even more important is coming back to the same assessment and measuring progress over time. By doing this patients can actually see the positive impact of lifestyle choices they are making and know that they are actually buying themselves years of healthy life. Finally, we’re bullish on Precision Health Reports because the company aligns financial incentives for employers. Health events like heart attack and stroke are incredibly expensive. Martin and his team are already working with corporate clients in law enforcement and in the tech industry to head off diseases before they become catastrophic, which saves money on healthcare costs while helping employees be more productive. 4 PRECISIONHEALTHREPORTS@STARTUPHEALTH.COM

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MEET THE HEALTH TRANSFORMERS

Augmental Tech’s Care Companion App for Parents of Neurodivergent Children Puts Parents at the Center With their app Tracto, South African co-founders Herman Lintvelt and Michael van der Linde, together with Karla Pretorius and Nanette Botha, both experts in the field of neurodiversity, are empowering parents of children diagnosed with autism spectrum disorder (ASD) or ADHD by simplifying caregiving and providing personalized parent support.

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MEET THE HEALTH TRANSFORMERS AUGMENTAL TECH / Any parent can testify that their to-do list feels neverending – groceries to buy, shoes to order, practices to get to, school projects, summer camp registration, holiday planning, and on and on. If you are the parent of a child who is neurodivergent or has a mental health diagnosis, that to-do list morphs into a truly Herculean task. There are doctor appointments to schedule, medications to take, symptoms to track, meetings with the school, sessions with a therapist, let alone making time to relax and connect with your child. From the moment a symptom presents itself in the child, that parent finds themselves on a new road, without GPS or even a map. Let’s say a teacher flags up a concern to a parent about their child’s behavior. The parent is then put in the driver’s seat to find information and make a plan to address the concern. They google it, sifting through information, deciding what to trust. They go to their pediatrician with a vague report from the teacher and the pediatrician either brushes off the concern or suggests a specialist that might not even be the kind the child needs. That specialist appointment takes six months or more to happen, all the while the child is struggling in school and falling behind. The parents grow confused and frustrated as they navigate this new terrain, and that’s all before there’s even any official diagnosis. If and when a diagnosis comes through, say autism or ADHD, the parent then becomes both the care coordinator and caregiver for their child, trying to get them what they need whether it’s occupational

therapy, psychiatric help, an individual education plan at school, or any other number of interventions. It’s a lonely, relatively thankless job. It’s little wonder that parental levels of stress increase significantly when you are parenting a neurodivergent child. Feelings of guilt and inadequacy are also common as parents question whether they are doing enough to help their child or choosing the right interventions. ORIGIN STORY

Herman Lintvelt and Michael van der Linde talk to many parents living this reality. The two met working together at a digital health company in South Africa and discovered a shared passion for addressing meaningful problems through technology. They started researching pain points in the healthcare system and were struck by a comment from a pediatrician friend who worked with neurodivergent children. He told them, “the information I have to work with is just incredibly low quality.” Even though parents want the best care and most accurate diagnosis for their children, it’s difficult to record and recall the data or even know what kind of things to look for and report. Without this good information, it’s hard for the pediatrician to then empower the parent in their role of getting their child what they need. As they examined the market, Lintvelt and van der Linde noticed that there was also very little support for parents managing care for their children with neurodevelopmental conditions. They decided to investigate further and sent out a survey to parents about their per-

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spective on the problem. The response was overwhelming. “We couldn’t believe how they opened up,” says Lintvelt. “We sent out a survey to about 300 parents and, in a week’s time, got over 200 responses literally telling us all the ways they are struggling, the assessments that take hours to complete, how it’s typical to wait six to seven months for an appointment.” With this line of communication now open with their target audience, Lintvelt and van der Linde began experimenting with how to make this caregiver and care coordinator role easier for parents. They officially co-founded the startup Augmental Technologies and put together a pilot, a rudimentary app that helped parents track symptoms, behaviors, medication, and appointments for their children. More than 150 parents signed up for it and began sharing incredibly personal stories and struggles with the two. The need for anything that would help was striking. “They were calling us and thanking us for this tool that was really just the bare minimum of what was possible. It spread through word of mouth, and all of

HEALTH TRANSFORMERS (L-R) Herman Lintvelt, CEO & Co-founder Michael van der Linde, CPO & Co-founder Karla Pretorius, Chief Clinical Officer augmental@startuphealth.com

a sudden we had this whole community of parents involved,” says van der Linde. “This community really helped shape the heart of what we decided to build out.” The duo soon realized that technology was not enough — parents also need emotional support, coaching, and a sense of community in a safe space. Their path crossed with Karla Pretorius and Nanette Botha, both having worked with neurodivergent families for more than 15 years, and the four immediately saw how each other’s skills and experience complement Augmental’s vision. Combining their backgrounds in user experience, behavioral science, product design and evidence-based therapy, and always driving the parents' perspective, they further evolved Tracto, Augmental Technology’s care companion app for parents. Tracto is already being used by startuphealth.com 71

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more than 1150 families. “This is for them, for the parents,” says Lintvelt. “This is a companion that helps them navigate all these challenges that they have, and supports them in their journey.” UNDER THE HOOD

At its most basic, Tracto is an app that helps parents navigate their child’s care journey and bring together other stakeholders such as teachers, clinicians, and therapists. It reminds the parent or other care partners when to administer medication, do activities, monitor side effects, and complete digital assessments, making sure nothing slips through the cracks. It also ensures that decisions are made based on the best information possible, taking some of the guesswork out of diagnoses and medication decisions. For example, take the medication titration process. Many patients have to go through a long trial and error process to find out which medication works best for them at which dosage. This process might be even more difficult with children who don’t know how to name side effects or who experience certain things while at school and don’t report back to their parents. With Tracto, both the parents and the teachers can log and observe side effects and get suggestions on what to look for. And not just adverse reactions – Tracto also helps members of a child’s care team look for positive impact, like creativity and attitude. “It works as a needle in the hand of a compass to make sure something is trending in the right direction,” says Lintvelt.

“Oftentimes you might not see a specialist more than once a year which is too long to wait to make a needed adjustment to medication. Tracto provides good data in a report form that makes it easy for a doctor to understand the situation so that adjustments can be made sooner with better results.” Throughout this process, Tracto places the parents in the driver’s seat. When they log in and set up an account in the app, they get to choose what to track, what they want reminders for and when, and who they invite to join their child’s team on the app. On the healthcare provider side, Tracto provides reports that are easy to print out or upload into an electronic health record. In addition to reminding, tracking, and reporting, Tracto provides online courses that equip parents with practical strategies on how to connect with and support their children - as well as their own well-being. Tracto personalizes course recommendations based on each family’s unique needs. If a parent indicates that their child diagnosed with ADHD’s sleep has them worried, the app will lead them to research on the topic of sleep and ADHD and suggest a course led by an expert on that topic. The tracking features are then used to help parents adapt the course learnings to their family’s unique needs. Augmental Tech has recently launched their first group parent coaching pilot program, both in the US and South Africa.. The intention is to refine how they can augment the shortage of specialist care providers using technology and evidence-based parent coaching. This super-

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vised peer coaching model takes some of the burden off the shoulders of the medical professional and cuts the wait time for parents who want to start taking meaningful steps in their child’s care now – not in six months when they finally have their appointment with a therapist. The founders see this practical approach to care as stemming from their South African mentality of making the most out of available resources. “We have a massive shortage of clinical skills to meet the need,” says van der Linde. “Our name ‘Augmental Technologies’ really says what we are about: we want to augment the parents’ lives with the tools we offer on this platform, and we want to augment the skill shortage with these trusted resources and coaching.” WHY WE’RE PROUD TO INVEST

When we met Herman Lintvelt and Michael van der Linde we were inspired by their approach to starting Augmental Tech. They began with an essential health moonshot question: How can we leverage technology to bring the most good to the world. They didn’t build a platform and then hope to find a market. They went to healthcare providers and patients and asked question after question, and then listened to the answers. We’re proud to back a startup that is so obsessive about listening to providers and patients and solving real world problems. We are also excited to back Augmental Technologies because they’re innovating in the Children’s Health Moonshot, an area that’s gotten comparatively little funding in recent years. Historically, par-

ents of children struggling with a mental health diagnosis haven’t been given many tools. They’ve been implicitly told that they need to face this burden alone and struggle in silence. But the ripple effects of untreated or under-managed mental health crises are vast, for both children and families. These problems deserve more focus, technology, and investment. As a global health company, we’re also excited to back this South African startup because of the ways they will bring their unique perspective to our community of Health Transformers. South Africa is at once a resource-constrained environment and a seat of technology and innovation. That has created a spirit of innovation – out of necessity – that results in rapid iteration and creative problem solving. The smaller market allowed Augmental Tech to experiment quickly with insurance companies and medical practices. We’re excited to see how they bring this experience to bear as they break into the American healthcare market. Finally, and most importantly, Herman, Michael, Karla and Nanette are using their experience and knowledge to bring wellbeing to children and families who have suffered alone. Their app Tracto is already helping hundreds of families thrive, and we can’t wait to see what they build next. 4 AUGMENTAL@STARTUPHEALTH.COM

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HEALTH TRANSFORMER Brandon Wynn, CEO & Founder glo@startuphealth.com 74 StartUp Health Magazine / TRANSFORMING HEALTH FOR EVERYONE

MEET THE HEALTH TRANSFORMERS

Glo is the Coaching App for Athletes That Helps Manage Mental Gymnastics Brandon Wynn, the most decorated gymnast on the rings in US history, founded Glo as a mental training platform to help youth athletes increase performance during competition, improve mental wellbeing, and increase their overall quality of life after their sports career ends.

MENTAL HEALTH & HAPPINESS MOONSHOT VINTAGE: 2022/Q2 WEGLO.CO

There’s been a long-running misconception that highlevel athletes don’t struggle with mental wellness obstacles. The generalization is that if you’re a good athlete at any age, your whole life must be good. The truth is that athletics amplifies stress, it doesn’t eliminate it. The anxiety connected with high-level performance, if not properly managed, can permeate into the rest of the athlete’s life. Traditional coaching principles, which haven’t changed much over the years, don’t help the situation. Coaches often employ scarcity tactics or punishment to get an athlete to perform. Improve your score or you’re off the team. Make the shot or you’re back on the bench. These coaching tactics can get an ath-

lete to perform in the moment but never create long-term success. These tactics also create a deep well of anxiety by attaching one’s personal worth to their value on the field. What if I don’t win? What if I don’t score well? What if I get cut from the team? These questions of self worth and identity then bleed into normal life once the competition is over, building and compounding over the years. When athletes struggle with the anxiety of performance, they are often stigmatized, made to feel that they aren’t strong enough to win. As a result, they push the feelings to the side, which has two negative effects. The first is a lack of basic mental healthcare for athletes, whose problems have been minimized and marginalized. The second is a lack of mental performance coaching that is targeted at elite athletic startuphealth.com 75

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performance. Think of it this way. We all know that elite athletics has a significant mental component. If a young athlete wishes to become an Olympian, they might need to up their mental game as much as the physical. But to get professional mental performance guidance in order to perform better means admitting you have a challenge, which athletes are trained to deny. It’s a Catch-22. Plus, there simply aren’t enough good mental performance coaches trained in this area. Athletes are lacking targeted support from mental performance professionals who understand what it’s like to compete at a high level. Now, a new startup is taking on the challenge in order to help young athletes thrive in the face of everyday anxiety and then master the stress of elite performance. ORIGIN STORY

After being recruited to Ohio State University, Brandon Wynn had a successful career in gymnastics on Team USA for eight years. He won a world championship medal, is the most decorated gymnast on the rings in US history, and has since been inducted into the Ohio State University Hall of Fame. As a professional in the high-pressure world of elite gymnastics, Wynn knew mental training was the number one variable to optimize his performance and increase his overall quality of life. Still, he wasn’t sure where to seek this type of coaching and was shocked by the fact that it was nearly impossible to find coaching he could trust.

Throughout his career, especially before crucial competitions, Wynn says he, along with his teammates, would need to find their own make-shift strategies to deal with the heat of the competition. “It’s always a moving target and a constant battle to find the right mindset, for today, this moment, to compliment the version of who you are today,” says Wynn. “All the mental positioning strategies we would use were not things we were taught but strategies born from necessity. With everything we had on the line, to be left up to a young athlete’s best guess at the right mental strategy seemed ridiculous.” “Without a consistent mental strategy and tools to help you deal with the heat of competition, there will always be a frantic energy behind everything you do, and something as physically taxing as a three-hour-long competition drains your resources. The right mental strategy is absolutely make or break.” Wynn knew from experience that there was a gap in the market, an urgent need for mental performance coaching that understood the individual. He realized that mental performance training didn’t need to be mystical or detached but could be highlypersonalized, data-driven, and woven into the fabric of an individual’s training. The result, if done right, would be a better experience for trainee and coach and result in more consistent results on and off the field. That seed of an idea became what is now Glo. UNDER THE HOOD

Glo creates a union between an athlete’s high demand for mental performance

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coaching and certified, industry-leading mental performance coaches while ensuring quality through one portal, brand, and company. The platform helps youth athletes develop skills to handle high-pressure situations, which not only dramatically helps an athlete win, but improves their emotional intelligence, helping them handle difficult situations later in life. Athletes learn that focusing on having a high level of mental fitness isn’t for athletes “with a problem.” Instead, it is for athletes who want to utilize every opportunity possible to win and “enjoy the ride to the top.” When athletes join the platform, they undergo an assessment with one of Glo’s mental performance coaches. The pair will identify the overall goals, skills the user already possesses, and where they are lacking. The coach will create a mental training plan and choose the tools to advance the

athlete’s skills to reach their goals. An example of an exercise provided to build mental resilience is breathwork, accounting for one’s inhale, holding at the top, and exhaling. Such an exercise slows down one’s heart rate, reduces the rate at which the athlete burns energy, and allows for increased focus. Coaches provide tips on implementing breathwork during competition, making custom recommendations for the athlete’s individual needs. There’s also an element of cognitive behavioral therapy for athletes who wish to enhance their top performance for competition. Coaches provide a deeper understanding of how an athlete’s life experiences, such as with school or their relationships, affect their athletic performance. All interaction with the Glo platform is digital. The training plan is implemented startuphealth.com 77

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through digital sessions, and the curriculum is based on Glo’s in-house learnings via coaching athletes with years of experience as the top mental performance coaches. Once a coach identifies the proper resources necessary for the athlete, a resource library is also available. A significant component of the platform is improving accessibility through text messaging. A coach and athlete can form a bond and provide and receive support regularly between sessions. When an athlete seeks to better perform in their sport, improve their mental wellness, and obtain the skills to do so, they can then handle different life events and inevitable anxieties, allowing them to flourish in all future circumstances. Glo’s focus is on ensuring athletes know that proactive mental training is just as essential as physical training and aims to help athletes handle any situation effectively and thoughtfully for the greatest possible outcome. WHY WE’RE PROUD TO INVEST

One reason we’re excited to back Glo is that it’s a mental health platform by athletes, for athletes. Thanks to his years competing at the Olympic level, founder Brandon Wynn understands the mental strain of elite performance better than just about anyone. He’s utilizing that experience to pilot Glo with a budding group of high level youth athletes, where it’s tracking the success of athletic goals reached by athletes. This isn’t a tool in search of a customer. This is a founder who intimately understands a problem, is embedded with the challenge, and is solving that problem

one person at a time, from the ground up. We’re also proud to back Wynn and the Glo team because they’re opening up access to care in a unique way. When we think about stigmatized groups, we don’t immediately think about athletes, but a detrimental culture of coaching has created an environment where athletes are more hesitant to get the mental healthcare they need. Attacking that problem is a new way to help youth handle stress and anxiety, and we need every tool available to address this crisis. Because it’s not just about winning the match or scoring a perfect 10 — although Glo is dedicated to helping athletes improve. At the end of the day, this is about preparing athletes for the rest of their lives, so that they’re resilient human beings and have the mental skills to be healthy adults once their sports careers are over. Helping a generation of athletes better cope with life’s challenges and identify and control anxiety levels will improve emotional intelligence, benefiting all situations athletes face, whether relationship-based, work-related, or elsewhere. “We don’t want this to be just another platform and marketplace. We want Glo to be a platform that finally figures out and demystifies the process of mental training to increase one’s performance and quality of life. I want this for my life, and I want this for every athlete’s life,” Wynn states. 4 GLO@STARTUPHEALTH.COM

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MEET THE HEALTH TRANSFORMERS

Athelo Health’s Digital Platform Brings Holistic, Supportive Care to Cancer Patients at Every Stage of Treatment Co-founders Jessica Thurmond and Monica Schmiede saw a gap in cancer care: too few oncology specialists and too little support for patients in remission. With Athelo they’re leveraging the best digital health tools to bring wrap-around care to this population, with a focus on biometrics, supportive community, and health literacy.

END CANCER HEALTH MOONSHOT VINTAGE: 2022/Q2 ATHELOHEALTH.COM

HEALTH TRANSFORMERS (L-R) Jessica Thurmond, Co-CEO & Co-founder Monica Schmiede, Co-CEO & Co-founder athelohealth@startuphealth.com

“Congratulations, your cancer is in remission!” It’s the best news of your life. You exhale, pushing out of your lungs twelve months’ worth of waiting rooms and sleepless nights and painful treatments. Then the oncologist says, “We’ll see you in six months to discuss your scans.” You’re taken aback. Six months? For the last year you’d had near-constant medical care. You talked to your care team almost daily. This was your medical family, and now they’re sending you home to fend for yourself. What if the cancer comes back?

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Treating cancer and staying healthy during remission is a unique journey and requires nuanced care. Athelo is taking the best digital tools available and targeting them specifically at this market.

What if you can’t sleep for fear of a relapse? You might be in remission, but you still feel like a cancer patient, and you have questions! This is an incredibly common scenario. When a cancer patient is told they’re in remission, they’re thrown back into the world of self-managed health. Suddenly they’re on their own in figuring out their diet, understanding symptoms, and knowing when to call their doctor. The patient might buy a wearable to track their health but not understand how the metrics pertain to their disease. They might join an online forum for cancer survivors but not have confidence that the information on the feed is reliable. At the end of the day, the daily health needs of cancer patients are incredibly unique and the healthcare system isn’t set up to meet those needs unless the patient is in the throes of treatment or experiencing an emergency. There aren’t nearly enough oncologists in the world, and those we do have are mostly generalists, not specialists. And the challenge is only getting bigger. Ironically, the better we get at treating cancer the more patients there will be who are living with cancer

in remission. Cancer patients need digital tools that take into account their unique conditions and personal biometrics. They need holistic care between doctor visits. They also need educational material that’s clinically validated and written so anyone can understand. Enter Athelo Health. ORIGIN STORY

For Jessica Thurmond, this story starts when her mother was diagnosed with breast cancer in 1999. She was a descendant of the Wahpeton Oyate Sioux tribe out of South Dakota and her options for dependable sources of information and healthcare were limited. “She came from a disadvantaged background,” says Thurmond. “I saw firsthand at that time how a lack of education, support, and trusted resources negatively impacted her patient journey.” She passed less than a year after her diagnosis, at the age of 39. That experience has driven Thurmond ever since. It inspired her to attend graduate school at Vanderbilt University where her research focused on the intersection of neuroscience and translational health before

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moving into the clinical trial market for a decade, always looking for ways to build health equity and health literacy into her work. Eventually Thurmond made her way into the oncology space through her research in glioblastoma and has been working in cancer care ever since. During her time at a clinical research organization (CRO), Jessica met Monica Schmiede and found a kindred spirit. Monica’s grandmother passed away from cancer when Monica was a teenager. Although access to care was not an issue, Monica and her family resorted to filtering through news and journal articles for clues on how to improve her grandmother’s quality of life at home outside of the clinical setting. Decades later, this paradigm persists today. While Jessica specialized in clinical operations and development, Monica, who’d gone to business school at the London School of Economics, worked in business intelligence and strategy. Both were passionate about using new digital tools and platforms to improve care and open up access for cancer patients. In 2021 the two made the leap, starting a company aimed at making clinical trials more accessible to cancer patients. But then they realized that if their goal was to help as many people as possible, they needed to think even bigger than clinical trials. They realized that a growing challenge in the cancer market was the availability of holistic care for cancer patients in both treatment and remission, so they set their sights on the field of “supportive cancer care.” “There’s no shortage of investment in

cancer treatments,” says Schmiede. “Oncology is by far the largest area of investment in drug development, attracting over a third of all pharma investment and ongoing clinical studies. Despite this, we still see limited advancements fundamentally improving the patient experience, which is still very fragmented.” Before they wrote a single line of code, the two conducted more than a hundred interviews with experts, key opinion leaders in the industry, and patients in order to understand the pain points. They discovered that while the oncology market was still new to the application of wearables and remote monitors, the COVID-19 pandemic was speeding up adoption of digital health and paving the way for their idea. “We’re huge advocates of wearable devices for health optimization, and we’re big fans of accessibility,” says Thurmond. “We believe everyone should have access to high-quality, integrated care. And you shouldn’t have to go to medical school to understand your pathway.” And so, with binders full of interview data, the two set about building a digital health platform that supported cancer patients — starting with breast and gynecologic cancers — in a holistic, supportive way. UNDER THE HOOD

Athelo Health (whose name is meant to conjure the image of a fictionalized Greek goddess) is a platform deployed through a patient’s medical provider. The oncologist, wanting to provide a patient with wrap-around care between visits, startuphealth.com 81

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can prescribe the Athelo platform just as they would direct them towards physical therapy or to a counselor. Athelo gets to know the patient through an onboarding questionnaire that covers medical basics and also digs into a range of lifestyle details and desires. It might ask them about their sense of spirituality, diet preferences, or about their living situation, all in the name of providing more contextual, holistic care down the road. Once Athelo has a deeper understanding of the health history and lifestyle of the patient, it opens them up to a community of resources, becoming a daily digital companion. Athelo connects with a range of wearables, from Fitbits to Apple Watches, and tracks health data in the background. Patients are prompted to review their biometrics, and then given information to help them understand what the numbers mean given their particular type of can-

cer. What is heart rate variability? Why does it matter? How should I expect my numbers to look if I’m on an oral therapy vs. chemotherapy? If the patient didn’t sleep well, Athelo might offer some guided meditations or stretching routines to try to alleviate stress before bed and track if that helps sleep over the following nights. The name of the game is targeted, contextual health guidance and educational resources that anyone can understand. Athelo also connects patients with a peer community for greater human connection and support. This takes the form of moderated discussions around topics like nutrition, financial concerns, or symptom management. Consider the patient on the platform who has a new rash and is concerned it’s related to their cancer or treatment. The platform identifies that the patient is on immunotherapy and that rash is a common side effect of that therapy. The app

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can help them understand that the rash is common while also offering to loop in their caregiver. In this case, time is of the essence — sometimes patients quit their therapy because they have side effects that last too long. The app suggests alternate ways that the patient can deal with the rash, then informs the patient there is a group of patients on the app who are on immunotherapy and dealing with similar issues. Would they like to connect? For Athelo’s co-founders, the platform isn’t about re-inventing the wheel, at least at first. They look up to tech-savvy platforms that have provided holistic care, like Livongo and Omada. But Athelo offers a chance to do this important work in the cancer market, starting with breast cancer and then growing to the rest of oncology. Treating cancer and staying healthy during remission is a unique journey and requires nuanced care. Athelo is taking the best digital tools available and targeting them specifically at this market. WHY WE’RE PROUD TO INVEST

Athelo Health is a triple-threat startup, addressing challenges in cancer, access, and cost, all at the same time. Obviously, they’re tackling the challenges of cancer care, helping cancer patients live longer and thrive during recovery. By connecting patients to resources and supportive communities, Athelo is able to help keep patients on therapy longer and respond to problems faster. These tools save lives. But Athelo is also addressing issues of access. The vast majority of people suffering from cancer don’t live within driving distance of an oncologist who special-

izes in that particular type of cancer. Most community oncologists don’t have the luxury of specializing and rarely have the bandwidth to provide supportive care. They focus, and rightly so, on medical treatments, but there’s little time left to talk about areas like sleep and diet. Telemedicine tools designed for cancer care can open up that market, making highquality care available in every region and at every education level. Athelo is also designed to reduce the cost of care by cutting down on unnecessary hospitalizations and doctor’s visits. They’re going to accomplish that by empowering patients with information and support when they need it most. This aspect of the business will be essential as the healthcare industry moves towards more value-based business models. “In this new era of value-based care there are so many elements of patient care that payers are having to think about for the first time,” says Thurmond. “Mental health, for instance, has been grossly undervalued. But it’s pretty basic. Your body can only respond to a drug if it’s operating at its best. The burden of stress has a serious impact on drug efficacy.” We’re proud to back the Athelo Health team as they bring the best of digital health to the world of supportive cancer care. This is a startup that doesn’t just pay lip service to the idea of patient-centricity and health equity. It’s clearly in their DNA and we know that their focus on accessibility will guide their decisions as they build and scale the company. 4 ATHELOHEALTH@STARTUPHEALTH.COM

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Quickr Is Upgrading the Tech Stack for Primary Care While Empowering Patients to Act on Their Health Data For Ian Cash, a childhood tragedy that left him paralyzed became a catalyst for innovation. Now, with his three co-founders at Quickr, he’s helping primary care providers be more efficient, making health records more actionable, and helping patients access clinical trials.

ACCESS TO CARE MOONSHOT VINTAGE: 2022/Q2 QUICKR.HEALTH

The logistical hurdles inherent in basic healthcare delivery have become so normalized that we can forget they’re there. But we’ve got to bring them out into the light if we’re ever going to address them. Let’s start with a patient’s ability to access their own health records. After all, how can you make positive health choices if you don’t know your baseline? A parent can easily spend hours on the phone requesting health records for their child and then spend weeks waiting for them to be mailed across town. Or a patient can get blood drawn at a lab, and then three weeks later see a doctor at a clinic

HEALTH TRANSFORMERS Ian Cash, CEO & Co-founder Adam Bragg, CSO & Co-founder Alex Hansen, CTO & Co-founder Juan Solares, COO & Co-founder quickr@startuphealth.com

across the street. The clinic can’t access the labs, so they re-do them, or they fax a request for the results and more weeks of waiting go by. Delays like this cause an estimated $750B in waste annually. Plus, they have a real human cost when it comes to catching illness and disease early. A similar headache around data access exists on the healthcare provider side, though it takes a different shape. A typical primary care doctor running an independent clinic has to manage a half dozen platforms in order to keep track of patient records, scheduling, messaging, billing, and legal. Each bucket of data exists in its own environment, within a unique

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platform and vendor. Navigating between these zones of data, reconciling them, and creating redundancies costs providers a massive amount of time. In the end they spend nearly as much time clicking between screens as they do talking to their patients and planning a path toward a healthier life. The connecting tissue between these two challenges, and the inspiration for Quickr’s first product, is the reduction in administrative burden and the creation of a delightful user experience. The rationale was that in today’s world of Venmo money transfers and one-click Amazon ordering, it doesn’t make sense for patients to sit around waiting for faxes or for primary care physicians to waste precious minutes and clicks navigating disparate, antiquated systems. All while patients are kept from using their health data in practical ways. It’s time for a tech stack upgrade. ORIGIN STORY

When Ian Cash was 13 years old, he got sick. Really sick. It started out as the flu and then spiraled into something much worse. His white blood cells, instead of attacking the virus, went after his nerves, causing an autoimmune disorder called Guillain-Barre Syndrome. But it got worse. Instead of his white blood cells knocking out the protective layer around his nerves, which is common in this disorder, they destroyed entire nerves, leaving him paralyzed from the neck down for five years. Ironically, however, it wasn’t the trauma of this experience that inspired Cash to become a health tech entrepreneur. It was the care he received.

“When I tell people about that time, they always look at me with pity,” says Cash. “But that wasn’t a bad memory for me. Why? Because of my mom. I call her my health guardian. I was on a health journey and she always made sure I was on the right path. She had all of my records, knew how to communicate with my doctors, and made sure we always had what we needed.” Cash grew up and went to college and every time he’d tell his story he’d be reminded how few people had the benefit of a health guardian like his mother. Even though, by law, people have access to their medical records, the vast majority still don’t know how to access them, or what to do with them. The problem nagged at him while at school studying mechanical engineering and he quickly realized he was an entrepreneur at heart. He had to solve this problem in some way or at least take a swing. So he entered Draper University, a Silicon Valley incubator for would-be founders established by legendary investor Tim Draper. There, Cash met Adam Bragg, a Princeton grad who had already successfully launched a VC-backed company, and Juan Solares, a two-time founder. They converged at a hackathon where participants had to create a business around the concept of decentralization. Almost immediately the three united around the idea of decentralized patient data, exploring how they could use technology to get that data into patients’ hands in actionable ways. After the competition, they kept pushing on the idea and built out ways to keep startuphealth.com 85

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patient data secure. The idea immediately caught the attention of the folks at Draper University and, a few short months later, Tim Draper and his firm completed their investment in the team. That early infusion of capital allowed the team — now co-founders — to go full time with the company and recruit experienced CTO Alex Hansen. Quickr was born. UNDER THE HOOD

Quickr is initially attacking the market by building a medical practice platform for Direct Primary Care (DPC) clinics. These clinics were ripe for disruption because they operate on a subscription model, outside of insurance. DPC patients pay a monthly fee and then have unlimited communication with their provider. Cash and his team saw this as the perfect market to make their entrance because the focus is on preventative care and a positive patient experience. On top of all this, they found that the DPC tech stack left much to be desired. “They use old electronic medical record systems, old communication platforms, and old billing platforms,” says Cash. “They have to use all of these different aging systems to serve a single patient, and each DPC serves about 1000 patients.” They’re stuck with these old systems, adds Bragg, because enterprise systems like Epic are expensive to implement and don’t cater to small practices. Quickr combined all the typical software tools used by a DPC office into one easy-to-use platform, so that a physician could have messaging, billing, health re-

cords, and scheduling all in one interface. It’s an adaptive work environment where the provider can modify that dashboard to suit their preferences. It’s also intuitive: when the provider clicks on an appointment in the scheduling section, the patient’s records and message history automatically populate, giving the provider an instant snapshot. Quickr’s clients estimate that this will give them back 30% of their time, so they can focus on patient care and reduce costs. There are electronic health record systems that have been purpose-built for DPC clinics, companies like DrChrono and Elation, but Quickr is distinguishing itself through focusing on the provider’s user experience and by providing a channel for interaction between the provider and the patient. “We’re making it easy for patients to fill out forms, schedule appointments, chat with their doctor, and then look at their medical records, all in the same interface,” says Bragg, the company’s Chief Strategy Officer. The chat-driven interface encourages greater patient engagement, which then sparks a virtuous loop where the patient is now more likely to get involved in their own health. The patient-facing side of the app also features a full-body avatar which allows the patient to orient themselves around their own anatomy. If you want to review a hand x-ray, for instance, you can tap the avatar’s hand. DPC clinics are signing up for Quickr, but Cash is quick to emphasize that this is merely their foothold in the market. “The game plan here is to listen to pa-

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tients and learn so that we can adapt and grow,” says Cash. The goal is to quickly attach Quickr to a sizeable number of initial clinic customers, which each serve around 1000 patients. That will give them a steady operating income so that they can become solvent within their niche, which in turn buys them time to understand their customers and build out the features that they need most. WHY WE’RE PROUD TO INVEST

Ian Cash, Adam Bragg, Juan Solares, and Alex Hansen aren’t your typical health tech founders. For one, they’re not industry insiders. They studied finance, engineering, computer science, history, and philosophy. But they know that, and they’re using it to their advantage as they look to rethink health from the ground up. The Quickr team is young enough to take risks, and they’re willing to make waves if it means fighting for patient empowerment. We’re proud to back Quickr as they work to upend broken legacy systems that don’t serve physicians or patients. “Legacy EHR brands are building for large hospital systems, which care disproportionately about payor reimbursement risk, so it’s really misaligned with patients’ needs,” says Bragg. “That’s because payors currently have the power. But as we get more patients on board we’ll hopefully show how aggregated records can present patients with more affordable and more personalized care options. Then, when patients have a choice, they’ll choose the healthcare options that cater better to their health goals and offer a more personalized experience based on their health history.”

We’re also bullish on Ian Cash and the Quickr team because they’ve made some very smart early moves. By developing a sharp product for DPC physicians they’ve discovered a way to earn quick revenue while honing product features. Quickr’s first client signed on for a paid plan before the team had even finalized their product because their current workflow was so cumbersome. They had so many different programs running to handle messaging and billing and records and legal that they had to go out and buy a bigger computer monitor just to show all the screens necessary. Which speaks to one of Quickr’s early advantages. The people who will foot the bill for the software are also the people whose lives will be improved. The person writing the check is also the person gaining hours back in their life because of more streamlined systems. Once Quickr is embedded with DPC clinics, they’ll roll out a unique and innovative clinical trial offering. With patient consent, Quickr can present clinical trials to its patients as health opportunities, thus making patient engagement in decentralized clinical trials much less expensive. In the end, we’re proud to back Ian Cash and his team at Quickr because they’re passionate about empowering patients with data, and about helping physicians spend more time providing care and less time tapping and tabbing on a screen. These simple-yet-profound ideas are the building blocks of a health revolution that is still in its infancy and that could change the world for the better. 4 QUICKR@STARTUPHEALTH.COM

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HEALTH TRANSFORMERS Abdul Paravengal, CEO & Co-founder Lajesh Kolath, COO & Co-founder Sajith Nair, CTO & Co-founder hav@startuphealth.com

Meet hav., the Affordable, Scalable Wellness App Gaining Ground in Asia Abdul Paravengal saw firsthand how sedentary lifestyles were leading to chronic disease in Asia, so he and his team built a platform that uses smart financial incentives to motivate users to get and stay active. Best yet, their innovative business model allows them to offer these services for free in lower- and middle-income regions.

NUTRITION & FITNESS MOONSHOT VINTAGE: 2022/Q2

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HAV.LIFE

Some of the greatest challenges in health today are also the most banal. Hundreds of millions of people around the globe live sedentary lives, moving from kitchen to couch to desk without any real physical exertion to speak of. Many of these same people lack the sleep they need to stay healthy. Exercise and sleep are simple, clinically-validated ways to live longer, yet many people ignore them and slip slowly, almost imperceptibly, from young and healthy to overweight and chronically ill. Weight goes up, cholesterol goes up, and Type 2 diabetes is close behind. Small lifestyle decisions over time lead to an epidemic of preventable disease and death. In fact, 40M deaths each year are attributable to preventable lifestyle diseases. In addition to the human cost, this is a huge financial burden. It’s estimated that $974B is spent annually treating lifestyle diseases globally. In more affluent countries, that additional money needed for fitness and doctor visits and medications can be absorbed. In these regions, a massive market of fitness apps and wellness companies have risen to meet these needs for preventative health. But what about the hundreds of millions of people around the world suffering from lifestyle diseases who can’t afford additional healthcare costs? Conditions like Type 2 diabetes create a crushing, unsustainable financial burden across swaths of Asia and Africa, and there have been, to date, no broad-based programs that meet these people where they are — programs that align incentives for patients to get active, get sleep, and im-

prove their mental wellbeing. To address the burden of global lifestyle diseases caused by lack of exercise and sleep, a company needs to create a solution that is incredibly affordable, simple to deploy at scale, and has aligned financial incentives so that users want to engage. With their health “super app” called hav., that’s exactly what co-founders Abdul Paravengal, Lajesh Kolath, and Sajith Nair have built. ORIGIN STORY

When Abdul Paravengal was at university in Delhi, India, he was in peak physical condition. He was a college track athlete, running the 10,000 meter and competing regionally. But then he graduated and took a desk job working in logistics in Mumbai and everything changed. “I pretty much stopped every physical activity when I started working,” says Paravengal. Between good genetics and his years of training on the track, Paravengal was able to live this way for a decade, eating as much as he wanted and not getting enough sleep, without any visible outward impact. He still looked relatively fit and healthy. Then one day in his mid-thirties, after moving to Indonesia for a job, he looked down and didn’t like what he saw. “About a year after I moved to Jakarta I noticed the change, that I was getting a big belly,” says Paravengal. And with that new belly came other negative health markers, and the frightening reality that he was taking years off of his life. He tried to whip himself back into

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shape. He bought an Apple Watch to track his steps, then hired a personal trainer. But nothing seemed to stick. Even though he had the financial means to get assistance, he lacked motivation and a support system. At this point, most people would have thrown in the towel. But Paravengal had spent the last decade working in startups and investing in more than 100 companies, including 30 in the health and fitness space. He realized that for the most part, these startups were either tackling chronic disease or they were in the preventative health space targeting extremely motivated and affluent people. He knew his plight wasn’t unique, and that in fact hundreds of millions of people faced the same health hurdles but lacked his financial resources and properly aligned incentives. If he could solve these problems scalably, he knew he’d have a thriving business that helped countless people live longer, fuller lives. Step one was to build a rockstar team, so he tapped co-founders Lajesh Kolath and Sajith Nair, two experienced operators who understood platform development and deployment. Then they set about building an app that was simple and fun for users, affordable for employers and communities, easy to deploy at scale, and financially viable from a business perspective. hav. was born. They launched the business with an emphasis on the Indian and Indonesian markets since that is where the co-founders live and work, but they’re rapidly expanding into the Middle East (having added

Arabic as an in-app language option) and will be opening up the app to new markets this summer. Paravengal and his team have already hit a million app downloads in their first year, with 200,000 average daily users. UNDER THE HOOD

Like many health and fitness apps, hav. starts with an intake form that gathers important data on the user. Based on the initial assessment, the AI-driven platform will give the user a bit of hard truth: it will estimate how many years of life they may have lost due to lifestyle-related health choices (currently in beta testing). “Once we tell you how many years you’ve probably lost because of what you’ve done in the past, we start tracking your steps and sleep,” says Paravengal. The app measures these activities against healthy benchmarks and then begins to reward users for meeting health goals. That reward piece, and how it’s administered, is critical. Because as Paravengal experienced himself, with slow-moving chronic conditions, incentives are everything. The way this works on the hav. app is that users earn a digital currency that can be used to buy products in a store on the app. And this isn’t just any store. It’s a marketplace for local vendors, contextualized to the region, where hav. has negotiated discounts lower than users will find elsewhere. “Our store is almost always cheaper than the brand’s own website, even during promotional periods,” says Paravengal. They accomplish this through an advertis-

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ing model. In exchange for deep discounts, the brands gain exposure to the app’s hundreds of thousands of users. This business model works because hav. has been incredibly successful at signing on corporate clients, getting users on the platform, and getting them to refer friends

and family. In fact, they were able to hit one million downloads of the app in just a few months, with a total marketing spend of only $5k. Their strategy has been to work with corporations that have thousands of entry and mid-level employees, in industries like retail, aviation, and logistics. The app can be rolled out as an employee wellness program for nearly free — Paravengal estimates it at a fraction of a penny per install. “Let’s say you want to do an employee engagement initiative and you have five thousand employees. We might start with a group step-a-thon. One person who completes the step goal will get an Amazon voucher. That allows hav. to acquire these users in bulk. Once they’re in the app for this one company-sponsored activity, they’re invited into other activity challenges on the app.”

One of Paravengal’s core beliefs is that in order to tackle slow-burn lifestyle diseases, financial incentives have to be aligned for both the user and the company. In other words, to offer free preventative health to millions of people, hav. needs robust revenue streams. They tackle this in three ways. The first is through digital advertising on the app, capitalizing on the hundreds of thousands of users logging in each day. The second revenue line is through the in-app store where hav. earns a commission on every sale that is made. The third stream is through a branded debit card that users can apply for. This card, which is already available for use in India, earns hav. a transaction fee on every purchase. The debit card also serves a secondary purpose of helping hav. create smarter incentives. “The core of getting unmotivated people to be healthier is to make sure they get rewards that are meaningful to them,” says Paravengal. “If you have access to debit card data about where they spend their money on a day-to-day basis, you can personalize the rewards to brands they already like.” WHY WE’RE PROUD TO INVEST

If you’ve been following StartUp Health for any length of time, you’ll know that we’re all about the Access to Care Moonshot. We believe that it’s not enough to invent a new, shiny solution that keeps people healthy if only a sliver of the world gets to benefit from it. Innovative health ideas are just the beginning. Getting them to the world, regardless of geography and economics, is just as crucial. For that rea-

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“The core of getting unmotivated people to be healthier is to make sure they get rewards that are meaningful to them."

son, and many others, we’re proud to back Abdul Paravengal and his team at hav. They have taken a model for preventative health that has traditionally been reserved for the top 5% of wage earners and figured out a smart way to make it accessible to nearly everyone. That’s in part because they understand their audience and the financial realities at play. In many countries where they operate, people might earn only $300 per month. Adding an additional $50 per month for medications, doctors, and dietary changes simply isn’t feasible. We’re also proud to back hav. because they’re going the extra mile to become a financial resource for users. Not only are they offering everyday goods at deep discounts — making life a little easier — but they’re incorporating buy-now-pay-later financing. This helps cash-strapped users stretch their money to the end of the month. It’s a holistic approach that recognizes, smartly, that financial health has a strong role to play in physical health. Finally, we’re excited to invest in hav. because their product is sticky, and their

revenue models are sustainable. When they roll out a step-a-thon program with a large employer, they’re seeing 30%+ engagement. That’s because the app is lightweight, fun to use, and because the audience is primed, having been traditionally left out of the market. On the revenue side, Paravengal and his team are taking a multistream approach to make sure they’re able to continue offering high-quality services for free to the people who need them most. This is another case where doing good really can result in doing well. As impressed as we are that hav. hit one million downloads in a few months, we’re even more excited about where they go next, adding languages and opening up the app in other countries across Asia. They’re also working to add more health parameters into the mix, like heart rate, blood pressure, and oxygen saturation, all without requiring a wearable. 4 HAV@STARTUPHEALTH.COM

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Are You Ready to Transform Health With Us?

StartUp Health’s platform fuels health moonshots To the Health Transformers of the World: We created StartUp Health to help you, the entrepreneur, thrive, scale and ultimately achieve health moonshots. StartUp Health is educating, inspiring, and investing in a global army of Health Transformers to achieve health moonshots. Since 2011, we have supported more than 435 innovative health companies, and we’re just getting started. Entrepreneurs, learn how to apply at startuphealth.com/gettingstarted Investors, support a diverse portfolio of private health innovation companies at healthmoonshots.com Learn how you can help educate the next generation of Health Transformers at startuphealth.com startuphealth.com 93

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StartUp Health Launches Health Equity Moonshot at Clinton Global Initiative The effort, led by global entrepreneur and health equity expert Kaakpema “KP” Yelpaala, will build on StartUp Health’s health moonshot investment thesis, adding a strategic framework for supporting founders and patients from historically disenfranchised communities.

In May 2020, the murder of George Floyd sparked a global movement dealing with the ways in which society remains held back by systemic racism and implicit bias. This movement led to protests around the world and forced many companies to reexamine their posture and policies towards people and communities that have been historically marginalized, particularly based on race, gender, and ethnicity. Alongside this was the COVID-19 pandemic. Some people began working from home while lower-wage essential workers had to keep showing up, and got sicker as a result. Along with other factors, the pandemic quickly

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showed us that racial inequities in health in which everyone has a fair and just opwere worse than many people thought; portunity to attain their highest level of communities of color had markedly high- health.” Health equity is about reorienting er rates of morbidity and mortality when our innovation and our funding around compared to white populations. communities and people who have been COVID highlighted how our health- historically marginalized. There are chilcare system was failing Black and brown dren whose healthy futures are correlated communities, which in largely with their zip turn shined a light on codes. There are women broader, systemic health whose pain is systeminequity. According to atically under-treated the CDC (2020), the because of the color maternal mortality rate of their skin. We see for Black women is three pharmacy deserts and By not times higher than for healthy food deserts. intentionally white women, and Black Everywhere we look backing men are more likely to in health, there are imfounders from die from cancer, diabebalances in power and a diverse array tes, and stroke than their disparities in health of backgrounds white counterparts. In a outcomes. Health eqwe limit our 2022 study by Morgan uity is the broad project perspective, our Health and NORC of reshaping our health talent pool, and at the University of system and innovation ultimately our Chicago for people with ecosystem to be fair ability to succeed. employer-sponsored inand just, in the name of surance, the overall rates greater health for all. of anxiety and depression for self-identified lesbian, gay, or bi- StartUp Health Launches Health sexual enrollees were 13.3% and 14.1% re- Equity Moonshot spectively, far above the national average. At StartUp Health, we educate, inThese disparities also have significant, spire, and invest in the most innovative negative economic impacts on our soci- health entrepreneurs in the world — our ety. According to a report from Deloitte, global army of Health Transformers. We health inequities in the US cost about launched a Health Equity Moonshot at $320 billion today and can cost the US the Clinton Global Initiative in order to health system over $1 trillion by 2040 if build a framework that reorients these not addressed. inspiring problem solvers to tackle the There are many ways to frame health challenge beneath the challenge, the social equity. The CDC defines it as “the state and systemic factors that drive health in-

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(L-R) Steven Krein, CEO & Co-founder, StartUp Health; Elizabeth Dale, Chief Development & Investor Relations Officer, StartUp Health; KP Yelpaala, Chief Impact Officer, Health Equity Moonshot – photographed at the 2022 Clinton Global Initiative.

equities. This transformative initiative will be integrated into all of StartUp Health’s health moonshots, breaking down silos and encouraging local and global collaboration. What does that look like? Perhaps you’re a startup using artificial intelligence to improve prenatal care. How are you orienting your product to make sure it’s available in low-income and rural communities where child mortality rates are the highest? Intentional and nuanced questions, aimed at challenging and supporting

founders early in the process, can create a cascade of impact and opportunity. Health equity isn’t just about addressing the health needs of historically marginalized and under-treated communities. It’s also about investing in a more diverse array of founders. Venture capital and healthcare startups are still dominated disproportionately by white men. By having too much homogeneity — by not intentionally backing founders from a diverse array of backgrounds — we limit our perspective, our talent pool, and ultimately

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If you take Black, Latinx, indigenous people of color, and women collectively, that represents 70% of the US population. However, founders from those backgrounds receive less than 10% of new venture funding. -KP Yelpaala, Chief Impact Officer for StartUp Health's Health Equity Moonshot

our ability to succeed. StartUp Health’s Health Equity Moonshot is a big tent. Any entrepreneurs or patients that have been mistreated, neglected, or marginalized in society — whether based on race, gender, or ethnicity — have a seat at this table and a voice in the discussion. But it’s not diversity for diversity’s sake. We’re not trying to find the perfectly color-coded stock image for our website. Investing in diversity of background and experience and thought, we increase our ability to understand challenges and address them in creative ways. According to research cited in the AMA In Full Health innovation report, teams with greater diversity have 19% higher revenue, 9% higher margins, and 33% higher quality patient care. This is not about checking a box. It’s about building a healthier future for everyone using the best tools available.

Health equity is the broad project of reshaping our health system and innovation ecosystem to be fair and just, in the name of greater health for all. STARTUP HEALTH’S APPROACH

Leading StartUp Health’s Health Equity Moonshot is Kaakpema “KP” Yelpaala, a global health entrepreneur and longtime StartUp Health portfolio company founder who has dedicated his life to reducing health inequities. Yelpaala is an American of Ghanaian heritage and sits at the intersection of the immigrant and Black experiences in the United States. “I see this as a tremendous opportunity in the US and globally,” says Yelpaala. “I deeply believe that any productive society needs a healthy population. Our economic wellbeing is tightly linked to the health and wellbeing of our population. To trans-

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form healthcare requires more diversity, equity, and inclusion in the digital health innovation landscape than exists today.” For Yelpaala, health equity moved from a mission to a deeply personal passion this year when he was diagnosed and treated for prostate cancer. Prostate cancer is the leading cancer in men but disproportionately kills Black men in the US. “I ended up being lucky that I was screened early, but many Black men are not as lucky.” Health equity isn’t a single effort, or a slogan, says Yelpaala. Creating a more equitable healthcare system and inclusive digital health innovation ecosystem requires a 360 degree approach. And that’s precisely why he’s optimistic about the initiative. “I am tremendously enthusiastic about the health equity initiative we are launching. Not only will we support a more diverse cadre of Health Transformers through investment, but we will also offer community support, curating opportunities for historically marginalized entrepreneurs to learn from each other and support each other. At the same time, we understand that diversity, equity, and inclusion in the innovation landscape benefits all. We will support all of our entrepreneurs in understanding the benefits of building diverse teams and how to operationalize that as they scale their companies.” Operationally, the Health Equity Moonshot will work in two directions simultaneously. On one end, we’ll look

impact players Since announcing its Health Equity Moonshot in September, StartUp Health has expanded the team that can guide a new framework for investing and coaching across multiple health moonshots. Here are four of these leaders:

Kaakpema "KP" Yelpaala Bio: CEO & Co-founder of InOn Health StartUp Health Role: Chief Impact Officer, Health Equity Moonshot Read more about Yelpaala on page 105

Aletha Maybank, MD, MPH Bio: Chief Health Equity Officer and SVP at the AMA StartUp Health Role: Health Equity Moonshot Impact Board Member

Chris Gibbons, MD, MPH Bio: CEO & Founder of The Greystone Group StartUp Health Role: Health Equity Moonshot Impact Board Member Read more about Dr. Gibbons on page 111

Sarah Oltmans Bio: Chief of Grant Strategy at Robin Hood StartUp Health Role: Type 1 Diabetes Moonshot Impact Board Member Read more about Oltmans on page 109

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back, engaging with our current portfolio of more than 400 health innovation companies around issues of diversity, equity, and inclusion. This will be a nuanced process of coaching and education. On the other end, we will look forward, launching new efforts to support entrepreneurs from underrepresented backgrounds, as well as entrepreneurs meeting the needs of marginalized communities. This effort will include an intentional investment model to back underrepresented founders. Guiding the effort, in addition to Yelpaala, will be a newly formed Impact Board dedicated to building an intentional and effective health equity framework. These experts, pulled from across the industry, will help break down silos and speed up progress on these nuanced issues. In turn, the diversity of this board will become a guide for all of StartUp Health’s impact boards. The Health Equity Moonshot will involve ongoing programming at StartUp Health Festivals and integration of health equity within StartUp Health’s university model. There will be dedicated efforts to create peer-to-peer engagement on Health Transformer Circles and we will open up the effort to global partners. These partnerships will help us raise scholarships for this moonshot so we can invite 100+ new founders for the Health Equity Moonshot into StartUp Health in the coming year.

health equity pledges without a clear understanding of what the outcomes would be. It’s with this in mind that StartUp Health is launching an intentional, longterm, and collaborative initiative to provide 360 degree support for founders and patients from historically marginalized populations. This is the beginning of a new work — and a way of thinking — that will last a lifetime and impact everything we do as a company. If you’re an investor who believes in this vision, we want to hear from you. Are you a founder focused on breaking down health barriers for historically marginalized communities or who has been held back based on systemic bias? We want to hear from you. Email healthequity@startuphealth.com

CONCLUSION

As soon as health equity emerged as a popular term it became a buzzword and a political football. Many companies made

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California Healthcare Foundation Innovation Fund Partners with StartUp Health to Support Diverse Founders

Every year, the venture capital industry invests billions in US-based companies, but most of that capital does not flow to Black, Latinx, and female-founded companies. This lack of funding creates missed opportunities for new products and services to solve problems, improve lives, and build wealth in communities of color. The California Health Care Foundation (CHCF) Innovation Fund and StartUp Health are teaming up to address this inequity by launching a 12-month initiative focused on Black, Latinx, and female health tech founders. The program will recruit and convene founders and support them via StartUp Health’s business development workshops, healthcare investor networks, and global communications platform. “We are excited to work with StartUp Health, one of the best-known platforms in the country supporting digital health companies and innovation,” said Janet Boachie, CHCF Health Equity Fellow. “StartUp Health is uniquely positioned to help female and/or founders of color receive greater access to relationships

and resources, which are critical for their success in developing a health care venture." Black founder-led companies received 1.2% of US venture capital investment in the first half of 2022, and Latinx founders received 2% of such funding in 2021, according to Crunchbase. That same year, female-only led startups accounted for nearly 2% of US venture capital, according to Pitchbook. The partnership aims to bring health care solutions to California’s MediCal program, the state’s version of Medicaid, a large market serving a third of Californians. The fund will make available experts to help entrepreneurs navigate the intricacies of Medi-Cal and health payer bureaucracies. “This work is important in supporting health equity,” said Ella Schwartz, CHCF Senior Program Investment Officer. “There are few programs that support tech-enabled health care services and entrepreneurs of color. We aim to change that by working with organizations like StartUp Health to educate, convene and advise founders working to address health access and quality of care issues.”

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scaling for impact

A Growing Cast of Health Industry Luminaries Join StartUp Health's Mission Each issue we interview new members of StartUp Health's board, team and investor community to learn what drives them, and why they're passionate about backing a diverse community of entrepreurs.

What has been a throughline for your professional life?

Sue Siegel, former CEO of GE Ventures, Joins StartUp Health's Impact Board to Advance Health Moonshots -----------

There are two things. One is the pursuit and absolute love of innovation. I have learned innovation is something that takes a bit of risk taking and "impatient patience." You have to know that it takes a long time for something innovative to become standard of care in medicine, about 17-20 years at the going rate. Entrepreneurs always think they can make that shorter, but there are systems and regulatory requirements that you have to learn along the way. The second is engaged leader-

ship; focusing on developing people and helping them reach their potential. Really good entrepreneurs know that from the beginning, and know how to bring people with them who truly know what that means. Helping people reach their full potential has brought me more joy than I can describe. Seeing them grow through the toughest problems, supporting them to pick a potential solution and go after it, and then watching them be successful - that is something I love, and helping entrepreneurs do that is a real joy.

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StartUp Health's New Partner and CFO Josh CherrySeto Previously Grew Blue Wolf Capital to $3B in Assets Under Management ----------You helped Blue Wolf grow from $100M to $3B of assets under management. What were some lessons you learned along the way? It’s all about relationships. My time at Blue Wolf Capital not only taught me to manage relationships with law firms, accounting firms and all the other interconnecting businesses, but also relationships with the companies we invested in. It’s a lot about getting to know the management teams and matching them with the right market experts. These are collaborative

conversations with people who really want to add value and take their companies to the next level. Companies are about people. The other pieces are important — I’m a CFO so I appreciate the numbers and the spreadsheets — but that’s table stakes. What really makes a difference is the people. The successful companies are those that understand how to get alignment on mission and execution. What drew you to StartUp Health? The fact is that healthcare is a huge opportunity for investment. We can argue over how much the system is broken, but we can agree it’s dysfunctional. And that’s true globally. There are a lot of inefficiencies, and that means there are massive opportunities. I believe in the triple bottom line of healthcare — you can achieve good returns, at lower costs while delivering better care to all the stakeholders affected. I’m also excited to move into the health innovation space because it’s such a

large universe. We don’t actually have to compete in terms of building successful companies. The sky’s the limit. We’re expanding the pie, not limiting it. It’s a rising tide that lifts all boats. In terms of the StartUp Health mindset, I really think collaboration is a path forward. In one sense investors often compete for transactions, but in reality the universe is big, and our aim is to be a meaningful collaborative partner to all and move the needle by substantially increasing the connectivity — creating the network effect that benefits all. That’s what I love about StartUp Health, that focus on making connections, building relationships, and building a global army of Health Transformers who are thinking not just about the next three to five years, but also moving towards global impact. You make the pie bigger, you don’t fight over one piece.

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Toby Cosgrove, MD, former CEO of Cleveland Clinic, Joins StartUp Health's Board of Directors ----------What do you think the world looks like over the next five to 10 years because of the pandemic and what we’ve been forced to both adopt and learn? First of all, we’ve learned that the world is interconnected. Diseases can no longer just stay in Africa or in Asia; they are something that is connected by airplanes, and they will go everywhere. The other big thing we really haven’t mentioned that has come out of this is the recognition of the disparity in healthcare delivery, which is really going to put an emphasis on more of the social

determinants of health. Only about 20% of health is related to what you get from a physician or a hospital. The rest are genomics and the social determinants, which really are enormous, and a lot of those boil down, frankly, to the economy. This has been a major reset in healthcare, and I think it’s made us think differently about things. I just started a book called Think Again by Adam Smith, a professor at the Wharton school. He says: Okay, let’s not hold all of these learnings as sacrosanct. Let’s rethink them and see if we can’t come to a better way of using our resources. And when you stop and think about it, COVID has made us do just that. It’s made us step back and, and think: Okay, we’ve now got data. We’ve got the major capabilities for dealing with it. And I think quantum computing is right on our doorstep, and we’re going to be able to deal with major data sets that we’ve never been able to deal with before and learn things from it. I think that COVID has given us the opportunity to do that.

Elizabeth Dale, EdD, Former Chief Development Officer at Jefferson Health, to Lead StartUp Health Business Development and Investor Relations ----------Is there a health moonshot that you are passionate about? I am excited about all of the moonshots, but I am passionate about the Health Equity Moonshot. This passion was ignited when I arrived in Philadelphia in 2006. At both Drexel University and Jefferson Health, fund raising for communitybased centers, programs and initiatives was a top priority. In March of 1966, Martin Luther King Jr. declared: “Of all the forms of inequality, injustice in health care is the most shocking and

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inhumane.” Now is the time and StartUp Health is the organization to lead in this transformation. It was thrilling to be with Steven Krein and Kaakpema “KP” Yelpaala at the Clinton Global Initiative conference for the launch of the Health Equity Moonshot. What has been a dominant theme of your career? The North Star that has guided me throughout my career has been an abiding commitment to make the world a better place. I had the privilege to serve in leadership roles in three missionbased organizations. They embodied strong cultures, resilient teams, focused decision-making capabilities, and were infused with creativity. StartUp Health’s mission to “improve the health and well-being of everyone in the world” builds on this experience. I love StartUp Health’s embracing the concept of a “double bottom line.” They achieve measurable financial and social outcomes.

Mike Mason, President of Lilly Diabetes, Joins StartUp Health's T1D Moonshot Impact Board ----------You’ve been with Eli Lilly since 1989. How have the company’s views on health innovation changed? In 2008/2009, we had a classical, functional approach where R&D independently determined what products we were going to bring to market. The problem with that is that it can prioritize what’s perceived as scientific innovation versus what really meets the needs of consumers and healthcare professionals. In 2009, we transitioned to a business unit approach. We have a business unit for every therapeutic area. Then we will drive the business

unit area that owns the commercial piece and the development piece, which work very closely with R&D on their priorities and targets. Magic happens when you get people who are very close to customers together with our medical, science, and development experts, and then we work through the most critical patient challenges. What role do you see the StartUp Health T1D Moonshot playing in pushing innovation forward? I think it’s a great, practical approach to helping advance care for diabetes. There are a lot of great ideas out there, but it doesn’t mean every great idea helps people living with a disease. I think entrepreneurs need support and they need financing. StartUp Health needs to pick through and differentiate between the good ideas and the not-so-good ones.

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Kaakpema "KP" Yelpaala, CEO & Co-founder of InOn Health, Leads StartUp Health's Health Equity Moonshot as Chief Impact Officer ----------What is your vision for the Health Equity Moonshot, and why is it necessary for a new initiative right now? Health disparities and health inequities have existed for decades. But the pandemic shined a light on it in a way that galvanized people. Something has to change. When we think about where we go from here, the innovation ecosystem is a big part of that. Many founders from minoritized backgrounds are doing the work. Not only building

innovative companies but also trying to build solutions to solve the challenges you find that drive those health disparities. We have a disproportionate burden of disease and mortality in those pockets. If you take Black, Latinx, indigenous people of color, and women collectively, that represents 70% of the US population. However, founders from those backgrounds receive less than 10% of new venture funding. And if we look at the funds making this investments, the same pockets of people I talked about manage around 1.3% of those dollars being invested. So, we're running into the brutal truth that we do not have enough investment going into minoritized founders and women. We don't have enough companies breaking through from pre-seed, seed, and Series A to scale solutions for these populations. That's the heart of the matter. There's a lot behind it, but that's what we're really looking to get into. There needs to be a 360-degree approach. On

the one hand, we’re talking about funding. There needs to be more funding, but not just that. Someone needs to lead the round. A lot of what these founders face is they can’t find a lead investor, but they have plenty of investors who say they will follow. That is a challenge for entrepreneurs generally, but it’s more of a challenge for founders of color and women. But if you go and run the numbers, you’ll find that founders of color, relative to other founders, have a harder time finding a lead. So we need venture to step up and lead early. That will create the successes that will get companies to Series A and B. We also need community. We can use StartUp Health Festivals to create a space on an ongoing basis for founders to share their stories and successes and to connect. And then the issue is, how do we track this over time and create accountability? I think StartUp Health, as a leader, is setting an intention and saying we know that we want to move to a better place.

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Robin Hood Chief of Grant Strategy Sarah Oltmans Brings Health Equity Lens to StartUp Health's T1D Moonshot ----------You bring the unique perspective of health equity related to poverty and access to the T1D Moonshot. Why is that perspective important? We need to make sure that treatments and cures are reaching underserved communities, across a range of issues, but especially on something like Type 1 diabetes. We’ve seen from the pandemic that we need different strategies and approaches to reach different communities, and that’s true for Type 1 diabetes. People face different

barriers. For example, we’ve seen that telehealth and digital health are not adapted to underserved populations, so we have to consider what needs to be changed in order to reach all people impacted by Type 1 diabetes. That’s the lens I bring: how do we need to adapt things, what are solutions that at first glance might not have as much reach but do have a different depth in terms of the lives they’re able to change. Your title is Chief of Grant Strategy — what role do grants play in today’s startup landscape? Should startups be seeing grants as a stronger strategic piece? It can be an important way to allow for innovation and early flexibility. The longer-term funding streams and dollars available are important for ultimately getting that reach, but philanthropic dollars can often be used at the innovation and flexibility stage, so I think it’s an important piece early on.

Jon Miller, former CEO of AOL and IAC, Appointed to StartUp Health's Board of Directors ----------How did you come to StartUp Health and get introduced to supporting health innovators globally? I’ve been in digital media for quite some time. I’m also an investor keenly interested in innovation, collaboration, and how you grow and scale companies. All those things became applicable when I met the folks at StartUp Health, whom I was introduced to by Esther Dyson. I was talking to her about my interest in this area some time ago, around health innovation and lessons I thought were generally permeating much of the world but which

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were not yet evident in the health sector. Esther agreed and said there was a place where that might occur. It’s called StartUp Health.

in Australia, the UK, and Germany.

Where do you see the greatest opportunity for impact in working on the StartUp Health Board?

The big boys have been playing in this area for a long time and we still don’t have a cure. We still don’t have equal access for everybody. So, I think what StartUp Health is doing is chipping away at some of these. And really, the quality and access issue is more significant than people realize.

At StartUp Health, we have a platform that is built to operate at scale, impacting every single company in the portfolio and many more. How do we do that? How do I work with the team to help make the platform and information processing as effective and impactful as possible because we now have a certain scale that allows us to think in those terms. In my experience, media systems are designed to scale. That’s what I’m always looking for and thinking about. That’s what we want to see with StartUp Health — operating at scale in order to dramatically reduce time to effectiveness in key areas of health.

What drew you to the StartUp Health model?

Claudia Graham, Former VP at Dexcom, Brings Deep Industry Expertise to StartUp Health's T1D Moonshot ----------What are you most proud of from your time at Dexcom? Ushering in continuous glucose monitors (CGM). We started domestically in the US, getting payers to cover these tools, including government and commercial payers. Then, once we had the evidence, we could go outside of the US and make some cost-effective arguments. The things I’m most proud of are getting Medicare coverage for CGM and insurance coverage, being able to use the apps, and working

What’s a piece of advice that you’d give to a founder who is early in the process of innovating around Type 1 diabetes? Make sure your idea is sound and that you have more money than you think you need. Talk to people that have been through it. Investors are pretty willing to share their story and pass it on. Also, the network within StartUp Health is a nice benefit for these entrepreneurs. Also, keep at it, but think it through.

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Chris Gibbons, MD, MPH, Founder & CEO of The Greystone Group, Joins StartUp Health's Health Equity Moonshot Impact Board ----------What was the turning point in your career when you realized the role innovation and digital health play in the conversation around health equity? The first came after my training at Johns Hopkins. I was doing a fellowship on The Hill at CMS (Centers for Medicare & Medicaid services) and data was beginning to show inequities in the United States. We’d heard about disparities in Europe, and minorities here kept saying there

were issues, but there was no consensus. The feeling was that by studying a single payer program, we could discover the level of imbalances, and Congress asked that we research the Medicare population to determine if there were variances, and if so, make recommendations. We discovered that, yes, there were large gaps in the Medicare population and while some people can get back into the system, immigrants, minorities, and those with English as a second language have more difficulty. What do you think is the unique role of StartUp Health's global army of health entrepreneurs in tackling health equity issues? This really excites me for a number of reasons. The government has had plenty of time to fix these inequities and they haven’t been able to. Not to blame anyone; it’s just the reality. Therefore, why would we continue doing the same thing and expecting a different result? In my mind, it’s time to look at new,

innovative places, and there is no better place to start than in the minds of people who are made from the DNA of change, the DNA of challenging conventional norms — not just for the sake of doing it but for the sake of overcoming problems that other people said were impossible. Someone said, “Everything is impossible until the first person does it.” I think this is a great challenge, and the right kinds of people are beginning to think about it. How can we be strategic about going upstream to support the future founders who understand the problems of underserved communities? We need to support people who can make an impact because they have lived experience within these communities, as well as individuals from these populations who also have innovation and technology expertise. We must involve these experts at every level of the design and development of these tools and more. startuphealth.com 111

STARTUP HEALTH NEWS: SCALING THE TEAM CHRIS GIBBONS, MD, MPH CONT'D

You bring up the point that you can’t just throw technology at a problem with the health equity label and assume it’s going to work. Are there ways you believe the industry could be getting it wrong? People from all walks of life and backgrounds can fall through the cracks in this healthcare system, but certain populations for a variety of reasons — language, whatever — have less of an ability to get back up in it. Now, let’s look at the technology side and the solution developer side. Unfortunately, 9598% of the people who are developing technologies to address these problems don’t look like the people coming from these populations and don’t have any real expertise with these populations. This means it’s hard to envision how the assumptions they make about the design of their products are the best hypotheses for communities in which they have no expertise. That’s probably one of the biggest areas of change needed. On top of

that, the products that get funded get built and that brings up another problem that needs to be solved — who’s funding what and why? One thing that makes you unique in this conversation is you are an academic and you have published papers about these topics. What would you like to see studied next in this field? While on one hand I feel we’ve studied enough and it’s time for us to do some things, I realize there is certainly more we need to understand. I can’t expect nor is anybody thinking that we should only have minority developers or funders. There are plenty of people from other communities, other races, other walks of life who want to do the right thing, but they honestly don’t know what to do. It’s simply not their background, but they want to know, they want to learn. Certain analyses are not accessible to everyone. Therefore, it’s very important to produce those academic papers, manu-

scripts, reports, and other insights in a digestible way to provide the necessary information. Say, “Okay, if you’re gonna do it differently, if you want to do it differently, this is what you need to think about, this is what you need to do, and this is how you need to do it.” Then point them in the right direction. We’ve published some of those papers and shared some of our research, but a lot more needs to be done in that area, and as we continue to study, we need to keep making our findings available. I believe that the vast majorty of entrepreneurs in StartUp Health want to push for health equity but perhaps don’t have the right tools or wisdom to know what that looks like. I agree with you. I believe that’s the vision of StartUp Health and others here, and those are the kinds of things that excite me about being invited and being a part of this process.

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“StartUp Health is my home base as a founder... They've provided exposure to investors and customer that I’d never have gotten on my own. They’ve given me support to accelerate faster and with more confidence.” -Troy Bannister CEO & Co-founder Particle Health

Entrepreneurs, learn how you can join StartUp Health at startuphealth.com

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At StartUp Health we work to inspire, educate, and invest in entrepreneurs who are working to address health moonshots – the greatest health challenges of our time. By organizing our portfolio around these global goals, we encourage collaboration and long-term thinking.

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ACCESS TO CARE COST TO ZERO DISEASE PREVENTION & CURES END CANCER WOMEN'S HEALTH CHILDREN'S HEALTH NUTRITION & FITNESS BRAIN HEALTH MENTAL HEALTH & HAPPINESS HEALTHY LONGEVITY & AGING ADDICTION & OPIOID CRISIS PANDEMIC RESPONSE TYPE 1 DIABETES HEALTH EQUITY ALZHEIMER'S DISEASE startuphealth.com 115

HEALTH MOONSHOT

Access to Care Together we can deliver quality care to everyone regardless of location or income

PORTFOLIO SPOTLIGHT

Toyin Ajayi, MD CEO & Co-founder Cityblock Health

Founded in 2017, Cityblock Health is a value-based healthcare provider for Medicaid and lower income Medicare beneficiaries. Cityblock partners with community-based organizations and health plans to deliver medical care, behavioral health, and social services virtually, in-home, and in community-based clinics. They use custom-built tools to support care team operations and member interactions. Cityblock serves more than 80k members across six states and Washington, DC, and partners include EmblemHealth, ConnectiCare, CareFirst, and Tufts Health Plan. The company was named a 2022 CNBC Disruptor 50.

SELECT PORTFOLIO COMPANIES

(Acquired by Press Ganey)

(Acquired by AmWell)

(Acquired by Sharecare & Generali)

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HEALTH MOONSHOT

Cost to Zero Together we can reduce the cost of care to “zero”

PORTFOLIO SPOTLIGHT

Ed Park CEO & Co-founder Devoted Health

Devoted Health was founded in 2017 to dramatically improve the health and wellbeing of older Americans by caring for each and every person like they are literally family. Combining a health insurer and medical group, Devoted provides all-in-one healthcare. Last year, the company raised $1.2B to expand its offerings nationwide, and currently serves nearly 80k Medicare Advantage members across five states. In 2023, Devoted plans to start serving members in eight more states.

SELECT PORTFOLIO COMPANIES

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HEALTH MOONSHOT

Disease Prevention & Cures Together we can rid the world of disease

PORTFOLIO SPOTLIGHT

Frank Westermann Co-CEO & Co-founder 9am Health

9am Health is virtual diabetes clinic providing affordable medications, labs, and personalized care for people living with prediabetes and Type 2 diabetes. The founding team sold their last company, mySugr, to Roche in 2017 for upwards of $100M. 9am Health raised $16M earlier this year, co-led by 7wire Ventures and Human Capital, and is currently available in 47 states and Washington, DC. Early data offers a glimpse into how people with diabetes will benefit from 9amHealth services, reporting an impressive A1c reduction of 1.8 points in members who had an A1c>8% prior to joining 9amhealth.

SELECT PORTFOLIO COMPANIES

(Acquired by Labcorp)

(Acquired by FamilyTreeDNA)

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HEALTH MOONSHOT

End Cancer Together we can end cancer as we know it

PORTFOLIO SPOTLIGHT

Kaitlin Christine CEO & Founder Gabbi

Gabbi is on a mission to decrease delayed diagnosis of preventable diseases for women, starting with breast cancer. The Gabbi Risk Assessment Model (GRAM) uses artificial intelligence to predict a woman’s two year risk of breast cancer. The Gabbi App provides a risk assessment, personalized action plan, and community support. The company completed a successful pilot with a national payor on the world’s largest claims dataset to train, test, and validate the GRAM, and will be starting a pilot this quarter with a self-funded employer with more than 60k members.

SELECT PORTFOLIO COMPANIES

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HEALTH MOONSHOT

Women's Health Together we can improve the health of every woman

PORTFOLIO SPOTLIGHT

Jill Angelo CEO & Founder Gennev

Gennev's mission is to empower women in their post-reproductive years. The company provides integrated menopause care through telehealth doctors, health coaches, products and education. Over 200k menopause assessments have been completed with 94% reporting symptom relief after their first visit. Gennev has a team of 25 menopause specialists (OB/ GYNs) across all 50 states. Media highlights include NBC’s Today Show, Oprah Daily, Forbes, Vogue, Real Simple, Well & Good, and Better Homes and Garden.

SELECT PORTFOLIO COMPANIES

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HEALTH MOONSHOT

Children's Health Together we can ensure that every child has access to high-quality care

PORTFOLIO SPOTLIGHT

Javier Evelyn CEO & Founder Alerje

Alerje is a Detroit-based company developing digital tools for food allergy management. In 2021, Alerje was granted a utility patent for their flagship epinephrine auto-injector smartphone case combo and received a Phase I SBIR grant from the National Science Foundation to develop a platform that collects, analyses, and distributes clinically relevant data to build a bridge between patients and their care teams. Alerje was named one of the best allergy apps by My Allergy Kitchen and was award an investment from the Black Founders Fund by Google for Startups.

SELECT PORTFOLIO COMPANIES

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HEALTH MOONSHOT

Nutrition & Fitness Together we can ensure access to food, water and a healthy lifestyle

PORTFOLIO SPOTLIGHT

Victor Penev CEO & Co-founder Edamam

Edamam organizes the world’s food knowledge and provides nutrition data solutions to health, wellness, and food businesses. Using a proprietary semantic technology platform, it delivers real-time nutrition analysis and diet recommendations via APIs. Edamam has built the most extensive recipe database in the industry with 5M+ recipes and 800k individual foods, each tagged for 40+ diets and 130+ nutrients to address over 200 chronic conditions. More than 90k companies have subscribed to their APIs and partners and clients include Amazon, Food Network, McCormick, Microsoft, and Nestle.

SELECT PORTFOLIO COMPANIES

(Acquired by Zimmer Biomet)

(Acquired by HealthLine)

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HEALTH MOONSHOT

Brain Health Together we can unlock the mysteries of the brain to improve health and wellbeing

PORTFOLIO SPOTLIGHT

Renee Ryan CEO Cala Health

Cala Health is on a mission to transform the standard of care for patients living with chronic diseases using non-invasive wearable neuromodulation therapies. Their lead product, the Cala Trio, is the only non-invasive prescription therapy for essential tremor. In 2020, the FDA granted Breakthrough Device Designation to Cala Trio for the treatment of action tremors in the hands of adults with Parkinson’s disease. Last year, the company raised $77M in new funding from investors including Ascension Ventures and Dolby Family Ventures.

SELECT PORTFOLIO COMPANIES

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HEALTH MOONSHOT

Mental Health & Happiness Together we can connect mind, body, and spirit in the pursuit of wellbeing

PORTFOLIO SPOTLIGHT

Tracy Dennis-Tiwary, PhD Chief Science Officer & Co-founder Wise Therapeutics

Wise Therapeutics uses breakthrough neuroscientific research to improve mental health through casual, accessible mobile games. In addition to their over-the-counter product, Personal Zen, Wise is developing a pipeline of mobile games to be reviewed and cleared by the FDA as standalone prescription digital therapeutics (PDTs). To date, they’ve published seven RCTs. Wise’s digital therapeutics have resulted in a 38% reduction in self-reported anxiety, 40% reduction in alcohol cravings, and a 9% reduction in stress hormone cortisol. Research collaborators and partners include NIH, NIMI, NYU Langone Health, Weill Cornell Medicine, and Soterix Medical.

SELECT PORTFOLIO COMPANIES

(Acquired by Dario Health)

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HEALTH MOONSHOT

Healthy Aging & Longevity Together we can add 50 healthy years to every human life

PORTFOLIO SPOTLIGHT

Satish Movva CEO & Founder CarePredict

CarePredict enables quality care, anywhere for seniors through its AI-powered digital health platform. Installed in over 80 facilities, CarePredict is currently monitoring over 8k people. According to research that studied 500 seniors over a two year period, the data collected through CarePredict’s wearable devices was able to reduce hospitalizations by nearly 40% and reduce falls by nearly 70%. Two thirds of the time, the data enabled seniors to remain in the same care setting without escalation. The company has over 20 issued utility patents in the US, France, Korea, and Canada.

SELECT PORTFOLIO COMPANIES

(Acquired by Sharecare & Generali)

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HEALTH MOONSHOT

Addiction & Opioid Crisis Together we can end addiction and the opioid epidemic

PORTFOLIO SPOTLIGHT

Yusuf Sherwani, MD CEO & Co-founder Quit Genius

Quit Genius is the world’s first digital clinic for treating nicotine, alcohol, and opioid addictions. Built on the evidencebased practice of Medication-Assisted Treatment (MAT), Quit Genius combines virtual behavioral therapy with approved medication and connected devices to help employers tackle the high cost of addiction in the workplace while improving the lives of their employees. To date, Quit Genius has helped more than 750k people quit their addictions and has published nine peerreviewed studies. Quit Genius grew revenue by 10x in 2021 and now partners with more than 100 employer and health plan clients covering 2.5M lives.

SELECT PORTFOLIO COMPANIES

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HEALTH MOONSHOT

Pandemic Response Together we can prevent, mitigate, and manage pandemics

PORTFOLIO SPOTLIGHT

Cristian Pascual CEO & Co-founder Mediktor

Mediktor is the most accurate AI medical assistant for triage and prediagnosis, directing patients to the right level of care. Their SAAS white labeled software is ready to be embedded into any interface and has been clinically validated with a success rate of up to 91.3% in trials with real patients. Initially created in Barcelona, Spain, Mediktor’s technology is available in 15 languages and the company is established in more than 25 countries, serving 10M+ users. Columbia Memorial Health in New York, serving more than 100k residents, recently launched the region's first digital "symptom checker" powered by Mediktor.

SELECT PORTFOLIO COMPANIES

(Acquired by AmWell)

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HEALTH MOONSHOTS IN DEVELOPMENT

Type 1 Diabetes Moonshot Launched: Summer 2022 T1D Moonshot Impact Board: david weingard,

Founder & Chairman, Cecelia Health; T1D patient & advocate; Chief Impact Officer, T1D Moonshot david panzirer,

Trustee, Helmsley Charitable Trust

aaron kowalski, phd,

CEO, JDRF International

jennifer sherr, md, phd, mike mason,

Professor, Yale School of Medicine

SVP & President, Lilly Diabetes

sarah oltmans,

Chief of Grant Strategy, Robin Hood

robert oringer,

Chairman & Board Director, AMG Medical

sean doherty,

Chairman, JDRF T1D Fund

claudia graham, phd, norma kenyon, phd,

Former SVP of Global Access, Dexcom

Deputy Director, Diabetes Research Institute

Contact: T1D@startuphealth.com

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Health Equity Moonshot

Alzheimer's Disease Moonshot

Launched: Fall 2022

Launch Schedule: Launching Early 2023

Health Equity Moonshot Impact Board:

Alzheimer's Moonshot Impact Board:

kaakpema

"kp" yelpaala, CEO

& Founder, InOn Health; Chief Impact Officer, Health Equity Moonshot aletha maybank, md, mph,

Chief Health Equity Officer & SVP, American Medical Association (AMA) chris gibbons, md, mph,

CEO & Founder, The Greystone Group

additional members to be announced

Contact: healthequity@startuphealth.com

mylea charvat, phd,

Former CEO, Savonix; Fellow, Stanford Neuroscience phyllis barkman ferrell,

Global Head of External Engagement, Alzheimer’s & Neurodegeneration, Eli Lilly meryl comer,

Co-founder, UsAgainstAlzheimer's craig ritchie, md, phd,

Director, Brain Health Scotland braden bishop,

Founder of 4MOM Charity; Professional Baseball Player peter kash, ed.d,

Co-founder, Belum Therapeutics Contact: alzheimers@startuphealth.com startuphealth.com 129

StartUp Health is on a mission to improve the health and wellbeing of everyone in the world.

We're inspiring, educating & investing in a global army of Health Transformers. These are the ambitious, collaborative entrepreneurs and innovators who are building companies that are solving the biggest health challenges of our time.

StartUp Health was founded in 2011 as an impactdriven company with a unique collaborative approach to break down traditional silos and significantly increase the likelihood of achieving health moonshots. Today, StartUp Health has the world’s largest ecosystem of health tech startups with more than 435 digital health and biotech companies, from pre-seed to post IPO, in 29 countries.

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THE STARTUP HEALTH FORMULA

Health Transformers x The Network Effect = Achieving Health Moonshots

StartUp Health Ecosystem

Health Transformers benefit from the StartUp Health Academy & Community Platform, which is designed to help health innovation companies become backable, survive, and thrive.

StartUp Health has assembled Health Moonshot Impact Boards, led by impact-aligned entrepreneurs, clinicians, investors, philanthropists, industry leaders, foundations, patients, and families.

Health Moonshot Framework

StartUp Health is backed by more than 150 impact-aligned investors and has an experienced team of professionals, faculty, and experts to help entrepreneurs succeed.

StartUp Health’s newest Health Equity Moonshot will embed health equity within all components of its model to support more inclusive innovation that reduces health disparities.

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PAUL FARMER, MD, PHD Dr. Farmer, founder of Partners in Health, dedicated his life to bringing care to the poorest communities in the world and inspired a generation of global health workers to do the same.

Dream Impossible At StartUp Health we help Health Transformers achieve health moonshots. Learn more at startuphealth.com 132 StartUp Health Magazine / TRANSFORMING HEALTH FOR EVERYONE