Ford isn't remaining idle while Uber and Lyft start medical transport services. It's launching a GoRide service that offers non-emergency transportation for patients who may have challenges reaching appointments on time. Health care providers can b…
What if there’s a drug that already exists that could treat a disease with no known therapies, but we just haven’t made the connection? Finding that connection by exhaustively analyzing complex biomechanics within the body — with the help of machine learning, naturally — is the goal of ReviveMed, a new biotech startup out of MIT that just raised $1.5 million in seed funding.
Around the turn of the century, genomics was the big thing. Then, as the power to investigate complex biological processes improved, proteomics became the next frontier. We may have moved on again, this time to the yet more complex field of metabolomics, which is where ReviveMed comes in.
Leila Pirhaji, ReviveMed’s founder and CEO, began work on the topic during her time as a postgrad at MIT. The problem she and her colleagues saw was the immense complexity of interactions between proteins, which are encoded in DNA and RNA, and metabolites, a class of biomolecules with even greater variety. Hidden in these innumerable interactions somewhere are clues to how and why biological processes are going wrong, and perhaps how to address that.
“The interaction of proteins and metabolites tells us exactly what’s happening in the disease,” Pirhaji told me. “But there are over 40,000 metabolites in the human body. DNA and RNA are easy to measure, but metabolites have tremendous diversity in mass. Each one requires its own experiment to detect.”
As you can imagine, the time and money that would be involved in such an extensive battery of testing have made metabolomics difficult to study. But what Pirhaji and her collaborators at MIT decided was that it was similar enough to other “big noisy data set” problems that the nascent approach of machine learning could be effective.
“Instead of doing experiments,” Pirhaji said, “why don’t we use AI and our database?” ReviveMed, which she founded along with data scientist Demarcus Briers and biotech veteran Richard Howell, is the embodiment of that proposal.
Pharmaceutical companies and research organizations already have a mess of metabolites masses, known interactions, suspected but unproven effects, and disease states and outcomes. Plenty of experimentation is done, but the results are frustratingly vague owing to the inability to the inability to be sure about the metabolites themselves or what they’re doing. Most experimentation has resulted in partial understanding of a small proportion of known metabolites.
That data isn’t just a few drives’ worth of spreadsheets and charts, either. Not only does the data comprise drug-protein, protein-protein, protein-metabolite, and metabolite-disease interactions, but they’re including data that’s essentially never been analyzed: “We’re looking at metabolites that no one has looked at before.”
The information is sitting in an archive somewhere, gathering dust. “We actually have to go physically pick up the mass spectrometry files,” Pirhaji said. (“They’re huge,” she added.)
Once they got the data all in one place (Pirhaji described it as “a big hairball with millions of interactions,” in a presentation in March), they developed a model to evaluate and characterize everything in it, producing the kind of insights machine learning systems are known for.
The results were more than a little promising. In a trial run, they identified new disease mechanisms for Huntington’s, new therapeutic targets (i.e. biomolecules or processes that could be affected by drugs), and existing drugs that may affect those targets.
The secret sauce, or one ingredient anyway, is the ability to distinguish metabolites with similar masses (sugars or fats with different molecular configurations but the same number and type of atoms, for instance) and correlate those metabolites with both drug and protein effects and disease outcomes. The metabolome fills in the missing piece between disease and drug without any tests establishing it directly.
At that point the drug will, of course, require real-world testing. But although ReviveMed does do some verification on its own, this is when the company would hand back the results to its clients, pharmaceutical companies, which then take the drug and its new effect to market.
In effect, the business model is offering a low-cost, high-reward R&D as a service to pharma, which can hand over reams of data it has no particular use for, potentially resulting in practical applications for drugs that already have millions invested in their testing and manufacture. What wouldn’t Pfizer pay to determine that Robitussin also prevents Alzheimers? That knowledge is worth billions, and ReviveMed is offering a new, powerful way to check for such things with little in the way of new investment.
ReviveMed, for its part, is being a bit more choosy than that — its focus is on untreatable diseases with a good chance that existing drugs affect them. The first target is fatty liver disease, which affects millions, causing great suffering and cost. And something like Huntington’s, in which genetic triggers and disease effects are known but not the intermediate mechanisms, is also a good candidate for which the company’s models can fill the gap.
The company isn’t reliant on Big Pharma for its data, though. The original training data was all public (though “very fragmented”) and it’s that on which the system is primarily based. “We have a patent on our process for getting this metabolome data and translating it into insights,” Pirhaji notes, although the work they did at MIT is available for anyone to access (it was published in Nature Methods, in case you were wondering).
But compared with genomics and proteomics, not much metabolomic data is public — so although ReviveMed can augment its database with data from clients, its researchers are also conducting hundreds of human tests on their own to improve the model.
The business model is a bit complicated as well — “It’s very case by case,” Pirhaji told me. A research hospital looking to collaborate and share data while sharing any results publicly or as shared intellectual property, for instance, would not be a situation where a lot of cash would change hands. But a top-5 pharma company — two of which ReviveMed already has dealings with — that wants to keep all the results for itself and has limitless coffers would pay a higher cost.
I’m oversimplifying, but you get the idea. In many cases, however, ReviveMed will aim to be a part of any intellectual property it contributes to. And of course the data provided by the clients goes into the model and improves it, which is its own form of payment. So you can see that negotiations might get complicated. But the company already has several revenue-generating pilots in place, so even at this early stage those complications are far from insurmountable.
Lastly there’s the matter of the seed round: $1.5 million, led by Rivas Capital along with TechU, Team Builder Ventures, and WorldQuant. This should allow them to hire the engineers and data scientists they need and expand in other practical ways. Placing well in a recent Google machine learning competition got them $200K worth of cloud computing credit, so that should keep them crunching for a while.
ReviveMed’s approach is a fundamentally modern one that wouldn’t be possible just a few years ago, such is the scale of the data involved. It may prove to be a powerful example of data-driven biotech as lucrative as it is beneficial. Even the early proof-of-concept and pilot work may provide help to millions or save lives — it’s not every day a company is founded that can say that.
Ford is launching an on-demand transportation service for non-emergency medical needs. The idea is to better help patients get to their doctor appointments. Ford is initially launching this in partnership with Beaumont Health in Michigan to serve more than 200 facilities.
Called GoRide, the fleet has 15 transit vans to accommodate people with varying needs. By the end of the year, Ford plans to have 60 vans, all driven by trained professionals, as part of GoRide’s services. The GoRide fleet can accommodate people with wheelchairs, thanks to flexible seats that can flip up and a wheelchair lift.
“There’s no excuse for the fact that so many people have trouble simply making it to their medical appointments,” Ford Mobility Business Group VP Marion Harris said in a press release. “By merging our expertise in vehicles, technology and human-centered design, we’ve created a high-touch, patient-focused service that truly understands and is tailored to patients and their needs. Our service is focused on multiple social determinants of health, and delivers the quality of care and on-time certainty that medical facilities need in order to increase throughput and reduce wait times.”
In March, Lyft committed to cut the problem of health care transportation in half by 2020. Lyft provides API access to partners like Allscripts, Blue Cross Blue Shield and Ascension to integrate the ride-hailing service into its health platforms and electronic health records services.
Meanwhile, people seem to be moving toward on-demand platforms for trips to the emergency room, as well. Last December, a study reported ambulance use has gone down about 7 percent nationwide since the rise of Uber.
Though, neither Uber or Lyft are particularly accessible to people with mobility disabilities. In March, Disability Rights Advocates, on behalf of the Independent Living Resource Center and two people who use wheelchairs, filed a class-action lawsuit today against Lyft. The plaintiffs allege the ride-hailing company discriminates against people who use wheelchairs by not making available wheelchair-accessible cars in the San Francisco Bay Area. Uber also faces a number of lawsuits pertaining to the lack of services it offers to people with mobility disabilities.
In Ford’s pilot program with Beaumont Health, GoRide was on schedule 92 percent of the time in regards to pick-ups and drop-offs. The average wait time for on-demand pick-ups for those needing wheelchair transport was between 10 to 30 minutes.
In a statement, Beaumont Health’s Paul E. LaCasse said, “This is precisely what we needed to improve access to medical care at Beaumont’s facilities for our patients who are elderly, in wheelchairs or have mobility challenges.”
In 1983, Chuck Hall, the father of 3D printing, created something that was equal parts simple and earth-shattering. He manufactured the world’s first-ever 3D printer and used it to print a tiny eye wash cup.
It was just a cup. It was small and black and utterly ordinary looking. But that cup paved the way for a quiet revolution, one that today is changing the healthcare industry in dramatic ways.
As healthcare costs in America continue to skyrocket, with no political solution in sight, this technology could offer some direly needed relief.
Here are just some the ways in which 3D printing is already revolutionizing the healthcare industry.
I love to tell the story of Amanda Boxtel, who came to me a few years ago complaining that her robotic suit, a gorgeous piece of design from Ekso Bionics, was uncomfortable to wear. Amanda is paralyzed from the waist down, and while this suit gave her the gift of movement, it couldn’t give her the symmetry and freedom of range of motion that she, like all humans, craved.
Unlike traditional prosthetics, which are mass-manufactured like any other traditional factory-produced good, 3D-printed prosthetics are custom-tailored for each individual user. By digitally capturing Amanda’s unique measurements, I was able to build her a custom-fit suit, much like a tailor would, creating a beautiful, lightweight design that fit Amanda’s body down to each distinct millimeter. Today Amanda feels so limber and free in her suit that she is now learning how to walk in high heels.
This same technology is now being harnessed to create beautiful conformal ventilated scoliosis braces, supports for amputees and more.
Bioprinting and tissue engineering
Writing in a recent issue of the Medical Journal of Australia, the surgeon Jason Chuen alerted his colleagues to a major technological breakthrough that could eventually do away with the need for human organ transplants. Here’s how it works:
3D printing is performed by telling a computer to apply layer upon layer of a specific material (quite often plastic or metal powders), molding them one layer at a time until the final product — be it a toy, a pair of sunglasses or a scoliosis brace — is built. Medical technology is now harnessing this technology and building tiny organs, or “organoids,” using the same techniques, but with stem cells as the production material. These organoids, once built, will in the future be able to grow inside the body of a sick patient and take over when an organic organ, such as a kidney or liver, fails.
3D-printed skin for burn victims
It may sound like something out of Mary Shelley’s “Frankenstein,” but the implications — and cost savings — make this technological breakthrough in 3D printing particularly immense. For centuries, burn victims have had incredibly limited options for healing their disfigured skin. Skin grafts are painful and produce terrible aesthetics; hydrotherapy solutions offer limited results. But researchers in Spain have now taken the mechanics of 3D printing — that same careful layer-upon-layer approach in which we can make just about anything — and revealed a 3D bioprinter prototype that can produce human skin. The researchers, working with a biological ink that contains both human plasma as well as material extracts taken from skin biopsies, were able to print about 100 square centimeters of human skin in the span of about half an hour. The possibilities for this technology, and the life-changing implications for burn victims, are endless.
Finally, 3D printing also has the potential to upend the pharmaceutical world and vastly simplify daily life for patients with multiple ailments. So many of us take dozens of pills each day or week, and the organization, timing and monitoring of these multiple medications and their diverse drug interactions and requirements (morning, night, with or without food) is utterly exhausting.
But 3D printing is the epitome of precision. A 3D-printed pill, unlike a traditionally manufactured capsule, can house multiple drugs at once, each with different release times. This so-called “polypill” concept has already been tested for patients with diabetes and is showing great promise.
The bottom line
The medical world, in which treatments, organs and devices are an integral part, stands to be revolutionized by the vast promises of 3D printing. With precision, speed and a major slash in cost, the way we treat and manage the health of our bodies will never be the same. And that’s something to celebrate.
I was pleasantly surprised by Motiv . Sure, my expectations were low for a fitness tracking ring, but pleasantly surprised is pleasantly surprised is still pleasantly surprised. The $200 Fitbit alternative gets a couple of key software upgrades this week, including, most notably, the addition of Android compatibility, along with some Alexa integration.
Initially launched as iOS-only, the Ring is taking baby steps toward working with the world’s most popular mobile operating system. It’s launching first as part of an open beta with, “a more comprehensive feature set” coming by middle of the year. But adventurous users can download the app from the Google Play Store right now.
The fitness tracking ring now works with Alexa, as well. Users can ask Amazon’s smart assistant to sync data and check their heart rate. More metrics are on the way by year’s end, in an attempt to save having to look at a phone screen every time, I suppose. After all, Motiv doesn’t seem likely to cram a tiny screen into the ring any time soon.
Speaking of Amazon, the Ring is now on sale through the online retail giant. Motiv will also be selling the ring at b8ta stores, for those who went to see it in person before dropping $200.
Walmart is in discussions to acquire medication delivery service PillPack for “under $1 billion,” reports CNBC. CNBC’s sources said the deal isn’t final yet, but talks have been going on for months and Amazon was also a potential suitor for the startup, which delivers medications to tens of thousands of customers in the United States.
Launched in 2013, PillPack has raised $118 million in funding from investors including Accel Partners, Atlas Venture and CRV. PillPack doesn’t just fill prescriptions: it also helps patients manage their medications by sorting pills into packets for individual doses, automatically delivering refills to homes and providing 24/7 customer service, all major selling points for seniors and people with multiple conditions. Last year, PillPack also unveiled prescription management software called PharmacyOS, which it described as “the first backend pharmacy system designed specifically for customers with complex medication regimes.”
Last November, co-founder and chief executive officer T.J. Parker, who trained as a pharmacist, said PillPack would do over $100 million revenue in 2017. It has a loyal customer base, who helped PillPack win a public relations battle in 2016 with Express Scripts, the country’s largest pharmacy-benefits manager. After Express Scripts cut off its partnership with PillPack, claiming that the company needed to be licensed as a mail-order operation instead of a retail pharmacy, PillPack said this would force it stop delivering to a third of its customers. It also accused Express Scripts, which runs its own home delivery service, of trying to block competition. Online outcry by customers, driven by a PillPack campaign, forced Express Scripts to back down.
Both Walmart and PillPack declined to comment on a potential acquisition to CNBC.
Amazon is said to be working on its own prescription delivery service, after launching a line of over-the-counter health products like allergy treatments. If its pharmacy business comes to fruition, that means Amazon will compete even more closely with Walmart, putting increasing pressure on the big-box store chain.
Walmart is also reportedly in talks to acquire health insurer Humana.
Hot on the heels of last week’s security issues, dating app Grindr is under fire again for inappropriate sharing of HIV status with advertisers and inadequate security on other personal data transmission. It’s not a good look for a company that says privacy is paramount.
Norwegian research outfit SINTEF analyzed the app’s traffic and found that HIV status, which users can choose to include in their profile, is included in packets sent to Apptimize and Localytics. Users are not informed that this data is being sent.
That said, it’s a rather serious breach of trust that something as private as HIV status is being shared in this way, even if it isn’t being done with any kind of ill intentions. The laxity with which this extremely important and private information is handled undermines the message of care and consent that Grindr is careful to cultivate.
Perhaps more serious from a systematic standpoint, however, is the unencrypted transmission of a great deal of sensitive data.
The SINTEF researchers found that precise GPS position, gender, age, “tribe” (e.g. bear, daddy), intention (e.g. friends, relationship), ethnicity, relationship status, language and device characteristics are sent over HTTP to a variety of advertising companies.
Not only is this extremely poor security practice, but Grindr appears to have been caught in a lie. The company told me last week when news of another security issue arose that “all information transmitted between a user’s device and our servers is encrypted and communicated in a way that does not reveal your specific location to unknown third parties.”
At the time I asked them about accusations that the app sent some data unencrypted; I never heard back. Fortunately for users, though unfortunately for Grindr, my question was answered by an independent body, and the above statement is evidently false.
It would be one thing to merely share this data with advertisers and other third parties — although it isn’t something many users would choose, presumably they at least consent to it as part of signing up.
But to send this information in the clear presents a material danger to the many gay people around the world who cannot openly identify as such. The details sent unencrypted are potentially enough to identify someone in, say, a coffee shop — and anyone in that coffee shop with a bit of technical knowledge could be monitoring for exactly those details. Identifying incriminating traffic in logs also could be done at the behest of one of the many governments that have outlawed homosexuality.
I’ve reached out to Grindr for comment and expect a statement soon; I’ll update this post as soon as I receive it.
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