Google is infamous for spinning up products and killing them off, often in very short order. It’s an annoying enough habit when it’s stuff like messaging apps and games. But the tech giant’s ambitions stretch into many domains that touch human lives these days. Including, most directly, healthcare. And — it turns out — so does Google’s tendency to kill off products that its PR has previously touted as ‘life saving’.

To wit: Following a recent reconfiguration of Google’s health efforts — reported earlier by Business Insider — the tech giant confirmed to TechCrunch that it is decommissioning its clinician support app, Streams.

The app, which Google Health PR bills as a “mobile medical device”, was developed back in 2015 by DeepMind, an AI division of Google — and has been used by the UK’s National Health Service in the years since, with a number of NHS Trusts inking deals with DeepMind Health to roll out Streams to their clinicians.

At the time of writing, one NHS Trust — London’s Royal Free — is still using the app in its hospitals.

But, presumably, not for too much longer since Google is in the process of taking Streams out back to be shot and tossed into its deadpool — alongside the likes of its ill-fated social network, Google+, and Internet ballon company Loon, to name just two of a frankly endless list of now defunct Alphabet/Google products.

Other NHS Trusts we contacted which had previously rolled out Streams told us they have already stopped using the app.

University College London NHS Trust confirmed to TechCrunch that it severed ties with Google Health earlier this year.

“Our agreement with Google Health (initially DeepMind) came to an end in March 2021 as originally planned. Google Health deleted all the data it held at the end of the [Streams] project,” a UCL NHS Trust spokesperson told TechCrunch.

Imperial College Healthcare NHS Trust also told us it stopped using Streams this summer (in July) — and said patient data is in the process of being deleted.

“Following the decommissioning of Streams at the Trust earlier this summer, data that has been processed by Google Health to provide the service to the Trust will be deleted and the agreement has been terminated,” a spokesperson said.

“As per the data sharing agreement, any patient data that has been processed by Google Health to provide the service will be deleted. The deletion process is started once the agreement has been terminated,” they added, saying the contractual timeframe for Google deleting patient data is six months.

Another Trust, Taunton & Somerset, also confirmed its involvement with Streams had already ended. 

The Streams contracts DeepMind inked with the NHS Trusts were for five years — so these contracts were likely approaching the end of their terms, anyway.

Contract extensions would have had to be agreed by both parties. And Google’s decision to decommission Streams may be factoring in a lack of enthusiasm from involved Trusts to continue using the software — although if that’s the case it may, in turn, be a reflection of Trusts’ perceptions of Google’s weak commitment to the project.

Neither side is saying much publicly.

But as far as we’re aware the Royal Free is the only NHS Trust still using the clinician support app as Google prepares to cut off Stream’s life support.

No more Streams?

The Streams story has plenty of wrinkles, to put it politely.

For one thing, despite being developed by Google’s AI division — and despite DeepMind founder Mustafa Suleyman saying the goal for the project was to find ways to integrate AI into Streams so the app could generate predictive healthcare alerts — the Streams app doesn’t involve any artificial intelligence.

An algorithm in Streams alerts doctors to the risk of a patient developing acute kidney injury but relies on an existing AKI (acute kidney injury) algorithm developed by the NHS. So Streams essentially digitized and mobilized existing practice.

As a result, it always looked odd that an AI division of an adtech giant would be so interested in building, provisioning and supporting clinician support software over the long term. But then — as it panned out — neither DeepMind nor Google were in it for the long haul at the patient’s bedside.

DeepMind and the NHS Trust it worked with to develop Streams (the aforementioned Royal Free) started out with wider ambitions for their partnership — as detailed in an early 2016 memo we reported on, which set out a five year plan to bring AI to healthcare. Plus, as we noted above, Suleyman keep up the push for years — writing later in 2019 that: “Streams doesn’t use artificial intelligence at the moment, but the team now intends to find ways to safely integrate predictive AI models into Streams in order to provide clinicians with intelligent insights into patient deterioration.”

A key misstep for the project emerged in 2017 — through press reporting of a data scandal, as details of the full scope of the Royal Free-DeepMind data-sharing partnership were published by New Scientist (which used a freedom of information request to obtain contracts the pair had not made public).

The UK’s data protection watchdog went on to find that the Royal Free had not had a valid legal basis when it passed information on millions of patients’ to DeepMind during the development phase of Streams.

Which perhaps explains DeepMind’s eventually cooling ardour for a project it had initially thought — with the help of a willing NHS partner — would provide it with free and easy access to a rich supply of patient data for it to train up healthcare AIs which it would then be, seemingly, perfectly positioned to sell back into the self same service in future years. Price tbc.

No one involved in that thought had properly studied the detail of UK healthcare data regulation, clearly.

Or — most importantly — bothered to considered fundamental patient expectations about their private information.

So it was not actually surprising when, in 2018, DeepMind announced that it was stepping away from Streams — handing the app (and all its data) to Google Health — Google’s internal health-focused division — which went on to complete its takeover of DeepMind Health in 2019. (Although it was still shocking, as we opined at the time.)

It was Google Health that Suleyman suggested would be carrying forward the work to bake AI into Streams, writing at the time of the takeover that: “The combined experience, infrastructure and expertise of DeepMind Health teams alongside Google’s will help us continue to develop mobile tools that can support more clinicians, address critical patient safety issues and could, we hope, save thousands of lives globally.”

A particular irony attached to the Google Health takeover bit of the Streams saga is the fact that DeepMind had, when under fire over its intentions toward patient data, claimed people’s medical information would never be touched by its adtech parent.

Until of course it went on it hand the whole project off to Google — and then lauded the transfer as great news for clinicians and patients!

Google’s takeover of Streams meant NHS Trusts that wanted to continue using the app had to ink new contracts directly with Google Health. And all those who had rolled out the app did so. It’s not like they had much choice if they did want to continue.

Again, jump forward a couple of years and it’s Google Health now suddenly facing a major reorg — with Streams in the frame for the chop as part of Google’s perpetually reconfiguring project priorities.

It is quite the ignominious ending to an already infamous project.

DeepMind’s involvement with the NHS had previously been seized upon by the UK government — with former health secretary, Matt Hancock, trumpeting an AI research partnership between the company and Moorfield’s Eye Hospital as an exemplar of the kind of data-driven innovation he suggested would transform healthcare service provision in the UK.

Luckily for Hancock he didn’t pick Streams as his example of great “healthtech” innovation. (Moorfields confirmed to us that its research-focused partnership with Google Health is continuing.)

The hard lesson here appears to be don’t bet the nation’s health on an adtech giant that plays fast and loose with people’s data and doesn’t think twice about pulling the plug on digital medical devices as internal politics dictate another chair-shuffling reorg.

Patient data privacy advocacy group, MedConfidential — a key force in warning over the scope of the Royal Free’s DeepMind data-sharing deal — urged Google to ditch the spin and come clean about the Streams cock-up, once and for all.

“Streams is the Windows Vista of Google — a legacy it hopes to forget,” MedConfidential’s Sam Smith told us. “The NHS relies on trustworthy suppliers, but companies that move on after breaking things create legacy problems for the NHS, as we saw with wannacry. Google should admit the decision, delete the data, and learn that experimenting on patients is regulated for a reason.”

Questions over Royal Free’s ongoing app use

Despite the Information Commissioner’s Office’s 2017 finding that the Royal Free’s original data-sharing deal with DeepMind was improper, it’s notable that the London Trust stuck with Streams — continuing to pass data to DeepMind.

The original patient data-set that was shared with DeepMind without a valid legal basis was never ordered to be deleted. Nor — presumably has it since been deleted. Hence the call for Google to delete the data now.

Ironically the improperly acquired data should (in theory) finally get deleted — once contractual timeframes for any final back-up purges elapse — but only because it’s Google itself planning to switch off Streams.

The Royal Free confirmed to us that it is still using Streams, even as Google spins the dial on its commercial priorities for the umpteenth time and decides it’s not interested in this particular bit of clinician support, after all.

We put a number of questions to the Trust — including about the deletion of patient data — none of which it responded to.

Instead, two days later, it sent us this one-line statement which raises plenty more questions — saying only that: “The Streams app has not been decommissioned for the Royal Free London and our clinicians continue to use it for the benefit of patients in our hospitals.”

It is not clear how long the Trust will be able to use an app Google is decommissioning. Nor how wise that might be for patient safety — such as if the app won’t get necessary security updates, for example.

We’ve also asked Google how long it will continue to support the Royal Free’s usage — and when it plans to finally switch off the service. As well as which internal group will be responsible for any SLA requests coming from the Royal Free as the Trust continues to use software Google Health is decommissioning — and will update this report with any response. (Earlier a Google spokeswoman told us the Royal Free would continue to use Streams for the ‘near future’ — but she did not offer a specific end date.)

In press reports this month on the Google Health reorg — covering an internal memo first obtained by Business Insider —  teams working on various Google health projects were reported to be being split up to other areas, including some set to report into Google’s search and AI teams.

So which Google group will take over responsibility for the handling of the SLA with the Royal Free, as a result of the Google Health reshuffle, is an interesting question.

In earlier comments, Google’s spokeswoman told us the new structure for its reconfigured health efforts — which are still being badged ‘Google Health’ — will encompass all its work in health and wellness, including Fitbit, as well as AI health research, Google Cloud and more.

On Streams specifically, she said the app hasn’t made the cut because when Google assimilated DeepMind Health it decided to focus its efforts on another digital offering for clinicians — called Care Studio — which it’s currently piloting with two US health systems (namely: Ascension & Beth Israel Deaconess Medical Center). 

And anyone who’s ever tried to use a Google messaging app will surely have strong feelings of déjà vu on reading that…

DeepMind’s co-founder, meanwhile, appears to have remained blissfully ignorant of Google’s intentions to ditch Streams in favor of Care Studio — tweeting back in 2019 as Google completed the takeover of DeepMind Health that he had been “proud to be part of this journey”, and also touting “huge progress delivered already, and so much more to come for this incredible team”.

In the end, Streams isn’t being ‘supercharged’ (or levelled up to use current faddish political parlance) with AI — as his 2019 blog post had envisaged — Google is simply taking it out of service. Like it did with Reader or Allo or Tango or Google Play Music, or…. well, the list goes on.

Suleyman’s own story contains some wrinkles, too.

He is no longer at DeepMind but has himself been ‘folded into’ Google — joining as a VP of artificial intelligence policy, after initially being placed on an extended leave of absence from DeepMind.

In January, allegations that he had bullied staff were reported by the WSJ. And then, earlier this month, Business Insider expanded on that — reporting follow up allegations that there had been confidential settlements between DeepMind and former employees who had worked under Suleyman and complained about his conduct (although DeepMind denied any knowledge of such settlements).

In a statement to Business Insider, Suleyman apologized for his past behavior — and said that in 2019 he had “accepted feedback that, as a co-founder at DeepMind, I drove people too hard and at times my management style was not constructive”, adding that he had taken time out to start working with a coach and that that process had helped him “reflect, grow and learn personally and professionally”.

We asked Google if Suleyman would like to comment on the demise of Streams — and on his employer’s decision to kill the project — given his high hopes for the project and all the years of work he put into the health push. But the company did not engage with that request.

We also offered Suleyman the chance to comment directly. We’ll update this story if he responds.

Israel-based AI healthtech company, DiA Imaging Analysis, which is using deep learning and machine learning to automate analysis of ultrasound scans, has closed a $14 million Series B round of funding.

Backers in the growth round, which comes three years after DiA last raised, include new investors Alchimia Ventures, Downing Ventures, ICON Fund, Philips and XTX Ventures — with existing investors also participating including CE Ventures, Connecticut Innovations, Defta Partners, Mindset Ventures, and Dr Shmuel Cabilly. In total, it’s taken in $25M to date.

The latest financing will go on expanding its product range and going after new and expanded partnerships with ultrasound vendors, PACS/Healthcare IT companies, resellers, and distributors while continuing to build out its presence across three regional markets.

The healthtech company sells AI-powered support software to clinicians and healthcare professionals to help them capture and analyze ultrasound imagery — a process which, when done manually, requires human expertise to visually interpret scan data. So DiA touts its AI technology as “taking the subjectivity out of the manual and visual estimation processes being performed today”.

It has trained AIs to assess ultrasound imagery so as to automatically hone in on key details or identify abnormalities — offering a range of products targeted at different clinical requirements associated with ultrasound analysis, including several focused on the heart (where its software can, for example, be used to measure and analyze aspects like ejection fraction; right ventricle size and function; plus perform detection assistance for coronary disease, among other offerings).

It also has a product that leverages ultrasound data to automate measurement of bladder volume.

DiA claims its AI software imitates the way the human eye detects borders and identifies motion — touting it as an advance over “subjective” human analysis that also brings speed and efficiency gains.

“Our software tools are supporting tool for clinicians needing to both acquiring the right image and interpreting ultrasound data,” says CEO and co-founder Hila Goldman-Aslan.

DiA’s AI-based analysis is being used in some 20 markets currently — including in North America and Europe (in China it also says a partner gained approval for use of its software as part of their own device) — with the company deploying a go-to-market strategy that involves working with channel partners (such as GE, Philips and Konica Minolta) which offer the software as an add on on their ultrasound or PACS systems.

Per Goldman-Aslan, some 3,000+ end-users have access to its software at this stage.

“Our technology is vendor neutral and cross platform therefore runs on any ultrasound device or healthcare IT systems. That is why you can see we have more than 10 partnerships with both device companies as well as healthcare IT/PACS companies. There is no other startup in this space I know that has these capabilities, commercial traction or many FDA/CE AI-based solutions,” she says, adding: “Up to date we have 7 FDA/CE approved solutions for cardiac and abdominal areas and more are on the way.”

An AI’s performance is of course only as good as the data-set it’s been trained on. And in the healthcare space efficacy is an especially crucial factor — given that any bias in training data could lead to a flawed model which misdiagnoses or under/over-estimates disease risks in patient groups who were not well represented in the training data.

Asked about how its AIs were trained to be able to spot key details in ultrasound imagery, Goldman-Aslan told TechCrunch: “We have access to hundreds of thousands ultrasound images through many medical facilities therefore have the ability to move fast from one automatic area to another.”

“We collect diverse population data with different pathology, as well as data from various devices,” she added.

“There is a Phrase ‘Garbage in Garbage out’. The key is not to bring garbage in,” she also told us. “Our data sets are tagged and classified by several physicians and technicians, each are experts with many years on experience.

“We also have a strong rejection system that rejects images that was taken incorrectly. This is how we overcome the subjectivity of how data was acquired.”

It’s worth noting that the FDA clearances obtained by DiA are 510(k) Class II approvals — and Goldman-Aslan confirmed to us that it has not (and does not intend) to apply for Premarket Approval (PMA) for its products from the FDA.

The 510(k) route is widely used for gaining approval for putting many types of medical devices into the US market. However it has been criticized as a light-touch regime — and certainly does not entail the same level of scrutiny as the more rigorous PMA process.

The wider point is that regulation of fast-developing AI technologies tends to lag behind developments in how they’re being applied — including as they push increasingly into the healthcare space where there’s certainly huge promise but also serious risks if they fail to live up to the glossy marketing — meaning there is still something of a gap between the promises made by device makers and how much regulatory oversight their tools actually get.

In the European Union, for example, the CE scheme — which sets out some health, safety and environmental standards for devices — can simply require a manufacturer to self declare conformity, without any independent verification they’re actually meeting the standards they claim, although some medical devices can require a degree of independent assessment of conformity under the CE scheme. But it’s not considered a rigorous regime for regulating the safety of novel technologies like AI.

Hence the EU is now working on introducing an additional layer of conformity assessments specifically for applications of AI deemed ‘high risk’ — under the incoming Artificial Intelligence Act.

Healthcare use-cases, like DiA’s AI-based ultrasound analysis, would almost certainly fall under that classification so would face some additional regulatory requirements under the AIA. For now, though, the on-the-table proposal is being debated by EU co-legislators and a dedicated regulatory regime for risky applications of AI remains years out of coming into force in the region.

Poland-based healthtech AI startup Cardiomatics has announced a $3.2M seed raise to expand use of its electrocardiogram (ECG) reading automation technology.

The round is led by Central and Eastern European VC Kaya, with Nina Capital, Nova Capital and Innovation Nest also participating.

The seed raise also includes a $1M non-equity grant from the Polish National Centre of Research and Development.

The 2017-founded startup sells a cloud tool to speed up diagnosis and drive efficiency for cardiologists, clinicians and other healthcare professionals to interpret ECGs — automating the detection and analyse of some 20 heart abnormalities and disorders with the software generating reports on scans in minutes, faster than a trained human specialist would be able to work.

Cardiomatics touts its tech as helping to democratize access to healthcare — saying the tool enables cardiologists to optimise their workflow so they can see and treat more patients. It also says it allows GPs and smaller practices to offer ECG analysis to patients without needing to refer them to specialist hospitals.

The AI tool has analyzed more than 3 million hours of ECG signals commercially to date, per the startup, which says its software is being used by more than 700 customers in 10+ countries, including Switzerland, Denmark, Germany and Poland.

The software is able to integrate with more than 25 ECG monitoring devices at this stage, and it touts offering a modern cloud software interface as a differentiator vs legacy medical software.

Asked how the accuracy of its AI’s ECG readings has been validated, the startup told us: “The data set that we use to develop algorithms contains more than 10 billion heartbeats from approximately 100,000 patients and is systematically growing. The majority of the data-sets we have built ourselves, the rest are publicly available databases.

“Ninety percent of the data is used as a training set, and 10% for algorithm validation and testing. According to the data-centric AI we attach great importance to the test sets to be sure that they contain the best possible representation of signals from our clients. We check the accuracy of the algorithms in experimental work during the continuous development of both algorithms and data with a frequency of once a month. Our clients check it everyday in clinical practice.”

Cardiomatics said it will use the seed funding to invest in product development, expand its business activities in existing markets and gear up to launch into new markets.

“Proceeds from the round will be used to support fast-paced expansion plans across Europe, including scaling up our market-leading AI technology and ensuring physicians have the best experience. We prepare the product to launch into new markets too. Our future plans include obtaining FDA certification and entering the US market,” it added.

The AI tool received European medical device certification in 2018 — although it’s worth noting that the European Union’s regulatory regime for medical devices and AI is continuing to evolve, with an update to the bloc’s Medial Devices Directive (now known as the EU Medical Device Regulation) coming into application earlier this year (May).

A new risk-based framework for applications of AI — aka the Artificial Intelligence Act — is also incoming and will likely expand compliance demands on AI healthtech tools like Cardiomatics, introducing requirements such as demonstrating safety, reliability and a lack of bias in automated results.

Asked about the regulatory landscape it said: “When we launched in 2018 we were one of the first AI-based solutions approved as medical device in Europe. To stay in front of the pace we carefully observe the situation in Europe and the process of legislating a risk-based framework for regulating applications of AI. We also monitor draft regulations and requirements that may be introduced soon. In case of introducing new standards and requirements for artificial intelligence, we will immediately undertake their implementation in the company’s and product operations, as well as extending the documentation and algorithms validation with the necessary evidence for the reliability and safety of our product.”

However it also conceded that objectively measuring efficacy of ECG reading algorithms is a challenge.

“An objective assessment of the effectiveness of algorithms can be very challenging,” it told TechCrunch. “Most often it is performed on a narrow set of data from a specific group of patients, registered with only one device. We receive signals from various groups of patients, coming from different recorders. We are working on this method of assessing effectiveness. Our algorithms, which would allow them to reliably evaluate their performance regardless of various factors accompanying the study, including the recording device or the social group on which it would be tested.”

“When analysis is performed by a physician, ECG interpretation is a function of experience, rules and art. When a human interprets an ECG, they see a curve. It works on a visual layer. An algorithm sees a stream of numbers instead of a picture, so the task becomes a mathematical problem. But, ultimately, you cannot build effective algorithms without knowledge of the domain,” it added. “This knowledge and the experience of our medical team are a piece of art in Cardiomatics. We shouldn’t forget that algorithms are also trained on the data generated by cardiologists. There is a strong correlation between the experience of medical professionals and machine learning.”

Fitness platform Ultrahuman has officially announced a $17.5 million Series B fund raise, with investment coming from early stage fund Alpha Wave Incubation, Steadview Capital, Nexus Venture Partners, Blume Ventures and Utsav Somani’s iSeed fund.

A number of founders and angel investors also participated in the Bangalore-headquartered startup’s Series B, including Tiger Global’s Scott Schleifer, Deepinder Goyal (CEO of Zomato), Kunal Shah (CEO of Cred), and Gaurav Munjal and Romain Saini (the CEO and co-founders of unacademy), among others. The latest tranche of funding brings its total raised to date to $25M.

While the subscription platform has been around since 2019, offering a fairly familiar blend of home workout videos, mindfulness content, sleep sessions and heart rate tracking (integrating with third party wearables like the Apple Watch), its latest fitness tool looks rather more novel — as it’s designed for monitoring metabolic activity by tracking the user’s glucose levels (aka, blood sugar).

Keeping tabs on blood sugar is essential for people living with diabetes. But in the US alone millions of people are prediabetic — meaning they have a higher than normal level of blood glucose and are at risk of developing diabetes, though they may not know it yet.

More broadly, Ultrahuman claims over a billion people in the world suffer from a metabolic health disorder — underlining the scale of the potential addressable market it’s eyeing. 

Having sustained high blood glucose is associated with multiple health issues so managing the condition with lifestyle changes like diet and exercise is advisable. Lifestyle changes can reduce elevated blood glucose and shrink or even avoid negative health impacts — such as by averting the risk of a prediabetic person going on to develop full blown diabetes.

But knowing what type of diet and exercise regime will work best for a particular person can be tricky — and involve a lot of frustrating trial and error — since people’s glucose responses to different food items can differ wildly.

These responses depend on a person’s metabolic health — which in turn depends on individual factors like microbiome diversity, stress levels, time of day, food ingredient and quality. (See also: Personalized nutrition startups like Zoe — which is similarly paying mind to blood glucose levels but as one component of a wider play to try to use big data and AI to decode the microbiome.) 

With metabolic health being so specific to each of us there’s a strong case for continuous glucose monitoring having widespread utility — certainly if the process and price-point can be made widely accessible.

Here, Ultrahuman is having a go at productizing the practice for a fitness enthusiast market — launching its first device in beta back in June — although the price-point it’s targeting is starting out fairly premium. 

The product (a wearable and a subscription service) — which it’s branded ‘Cyborg’ — consists of a skin patch that extracts glucose from the interstitial fluid under the skin, per founder and CEO, Mohit Kumar, with the data fed into a companion app for analysis and visualization.

Image credits: Ultrahuman

The patch tracks the wearer’s blood glucose levels as they go about their day — eating, exercising, sleeping etc — with the biomarker used to trigger the app to nudge the user to “optimize your lifestyle”, as Ultrahuman’s website puts it — such as by alerting the user to a high blood glucose event and suggesting they take exercise to bring their level down.

If the product lives up to its promise of continuous glucose monitoring made easy, lovers of junk food could be in for a rude awakening as they’re served fast feedback on how their body copes (or, well, doesn’t) with their favorite snacks…

“We use medical grade sensors that have been used in the sports technology domain for the last 6-7 yrs with decent accuracy levels,” says Kumar when we ask about the specifics of the wearable technology it’s using. (The sensing hardware is being ‘worn’ here in the sense that it’s directly attached to (i.e. stuck into/on) bare skin.)

While Ultrahuman’s platform has plenty more vanilla fitness content, the company is now billing itself as a “metabolic fitness platform” — putting the nascent product front and center, even though the glucose tracking subscription service remains in closed beta for now.

The startup is operating a waitlist for sign-ups as it continues to hone the technology.   

Ultrahuman touts “thousands” of people signed up and waiting to get their hands on the glucose tracker service — and says it’s seeing 60% week over week growth in sign ups, with wider availability of the product slated for “early 2022”.

Some of the Series B cash will be used to make improvements to the quality of the glucose biomarkers ahead of a full product launch.

On the enhancements side, Kumar tells TechCrunch the team is exploring “other form factors and other types of sensors that could help us capture glucose in a more accurate way and for a longer duration than 14 days”, as they work to hone the wearable. (The current version of the skin-worn sensor only lasts two weeks before it must be replaced with another patch.)

“We want to add more biomarkers like HRV [heart-rate variability], sleep zones and respiratory rate to help people understand the impact of metabolic health on their recovery/sleep and vice-versa,” he adds.

Ultrahuman says it decided to focus on tracking glucose as its “main biomarker” as it can be used as a proxy for quantifying a number of fitness and wellness issues — making it a (potentially) very useful measure of individual health signals.

Or provided the startup’s technology is able to detect changes to glucose levels with enough sensitivity to be able to make meaningful recommendations per user.

“Glucose is interesting because it is a real-time biomarker that’s affected by exercise, sleep, stress and food,” says Kumar, adding: “We are able to help people make lifestyle changes across many vectors like nutrition, sleep, stress and exercise vs being unidimensional. It is also highly personalized as it guides you as per your body’s own response.”

He gives some examples of how the product could help users by identifying beneficial tweaks they could make to their diet and exercise regimes — such as figuring out which foods in their current diet yield “a healthy metabolic response” vs those that “need more optimization” (aka, avoiding the dreaded sugar crash). Or by helping users identify “a great meal window” for their lifestyle — based in their body’s glucose consumption rate.

Other helpful nudges he suggests the service can provide to sensor-wearing users — with an eye on athletes and fitness fanatics — is how best to fuel up before exercise to perform optimally.

Optimizing the last meal of the day to improve sleep efficiency is another suggestion.

If Ultrahuman’s Cyborg can do all that with a (bearably) wearable skin patch and a bit of clever algorithmic analysis it could take the quantified self trend to the next level.

A simple stick-on sensor-plus-app that passively amplifies internal biological signals and translates individual biomarkers into highly actionable real-time personalized health insights could be the start of something huge in preventative healthcare.

Again, though, Ultrahuman’s early pricing suggests there will be some fairly hard limits on who is able to tap in here.

Early adopters in the closed beta are shelling out $80 per month for the subscription service, per Kumar. And — at least for now — the startup is eyeing adding more bells and whistles, rather than fewer. “[Product pricing] will mostly be in the same range but may introduce more services/premium features on top of this,” he confirms.

The (typically higher) cost of eating healthily and having enough leisure time to be able to look after your body by taking exercise are other hard socioeconomic limits that won’t be fixed by a wearable, no matter how smart.

If there’s one thing that the ongoing COVID-19 crisis has proven, it’s that the healthcare system in the U.S. is in drastic need of major transformation. One of the biggest issues to be highlighted by the pandemic in particular is the iniquity in access to care, but there are signs that one of the effects of COVID-19 will be a stepping up of accessibility reform driven in particular by technology.

At Disrupt 2021, we’re thrilled to have three guests onstage for a panel discussion all about how tech companies are working to address access gaps in healthcare. From Cityblock Health, we’ll host co-founder and Chief Health Officer Toyin Ajayi; from Carbon Health, co-founder and CEO Eren Bali; and from Forward, CEO and co-founder Adrian Aoun.

Cityblock Health is the first tech-driven provider for communities with complex health and social needs — bringing better care to neighborhoods where it’s needed most. Cityblock’s goal is to foster a model of care that meets individuals where they are, delivering highly personalized primary care, behavioral healthcare and social services to its members, with a focus on those who access Medicaid, are dually eligible for Medicaid and Medicare, and others living in lower-income neighborhoods.

Carbon Health has a goal of making good healthcare accessible to all, with same-day appointment booking, telehealth services and prescription delivery, facilitated through partnerships with some of the leading insurers and payers in the U.S. The company has taken a central role in vaccine administration in California, and continues to evolve its model of modular healthcare delivery to reach communities where primary care hasn’t traditionally been readily available.

Forward is an AI-based healthcare system combining world-class private doctors with new technology to enable proactive, data-driven primary care. Starting with cutting edge in-clinic and at-home biometric data measurement, Forward aims to tailor its primary care to individuals in a combination that delivers both scalability and personalization. The company also espouses a direct-to-consumer, subscription-based model of care that it argues avoids some of the traditional pitfalls of insurance-backed care.

We’re excited to be able to dig in to these very different approaches to healthcare, that still all share the fundamental goal of making a higher-quality standard of care available to more people.

During the three-day event, writer, director, actor and Houseplant co-founder Seth Rogen will be joined by Houseplant Chief Commercial Officer Haneen Davies and co-founder and CEO Michael Mohr to talk about the business of weed, BioNTech co-founder and CEO Uğur Şahin will dive into what’s next for mRNA technologies after COVID, and Coinbase CEO Brian Armstrong will dig into the volatile world of cryptocurrency and his company’s massive direct listing earlier this year.

Disrupt 2021 wouldn’t be complete without Startup Battlefield, the competition that has launched some of the world’s biggest tech companies, including Cloudflare and Dropbox. Join Ajayi, Bali, Aoun and more than 10,000 of the startup world’s most influential people at Disrupt 2021 online this September 21-23. Check out the Disrupt 2021 agenda here. We’ll add even more speakers soon.

Buy your Disrupt pass before September 20, and get ready to join the big, bold and influential — for less than $100. Get your pass to attend now for under $99 for a limited time!

Michelle Davey’s pitch to Jordan Nof of Tusk Ventures about Wheel, a startup focused on providing a full suite of virtual care solutions to clinicians, was front-loaded with early metrics. It may not be standard practice to start with the numbers, especially early on, but she explained to us why she chose that strategy — and Nof told us why it worked.

Davey and Nof joined us on a recent episode of Extra Crunch Live and went into detail on why Tusk was eager to finance Wheel, walking us through the startup’s Series A pitch deck and sharing which slides and bits clinched the deal.

Extra Crunch Live is a weekly virtual event series meant to help founders build better venture-backed businesses. We sit down with investors and the founders they finance to hear what brought them together, what they saw in each other and how they work together moving forward. We also host the Extra Crunch Live Pitch-Off, where founders in the audience can pitch their startups to our outstanding speakers.

Extra Crunch Live is accessible to everyone live on Wednesdays at noon PDT, but the on-demand content is reserved exclusively for Extra Crunch members. You can check out the full ECL library here.

When to lead with traction

Davey emphasized the importance of not sticking to a rigid format for building a pitch deck. She said it’s important to instead focus on crafting your pitch around what makes you appealing and unique. That should be on the foreground and featured prominently.

For Wheel, that meant leading with traction, since the company had impressive uptake even early on. That remained true for their recent Series B raise, too.

As more businesses around the U.S. are choosing to implement vaccine requirements for patrons or staff, business discovery and review site Yelp is introducing new tools that allow businesses to communicate those changes to their customers. On Thursday, Yelp will begin rolling out two profile attributes, “Proof of vaccination required” and “Staff fully vaccinated,” to help consumers to understand how a business is operating with regard to the pandemic.

While there is no federal mandate for businesses to require proof of vaccination, some cities are introducing their own policies. Recently, New York City became the first to require proof of vaccination for indoor restaurants and gyms, and, San Francisco is now exploring a similar set of mandates. Other cities may choose to follow suit in the future.

In addition, local business owners across the U.S. are implementing their own measures outside of federal or state guidance, including requiring masks or proof of vaccination for customers, or requiring their staff to be vaccinated. These choices often come at price, as the businesses risk social media backlash and bad reviews from the anti-vaccine crowd.

Yelp’s new features will represent an attempt to help mitigate that reaction, the company explains.

Image Credits: Yelp

Yelp says it will proactively leverage a combination of automated systems and human moderators to safeguard businesses from attacks from customers if a business opts to activate either of the two new options related to their Covid vaccine policies.

Though the company has long since had systems in place to address “review bombing” incidents, Yelp says the practice has gotten worse in recent months.

In the past, businesses that gained negative public attention may have had an influx of reviews from those who didn’t have a first-hand experience with the business in question, which violates Yelp’s policy. Yelp may then alert visitor to the business’s page that there’s the potential for fake reviews or that thee had been spikes in unusual activity. The company will sometimes even temporarily block users from being able to leave reviews. And in some cases, Yelp will also need to remove false reviews or those that otherwise violate its policies.

But since January 2021, Yelp says it’s had to place over 100 Unusual Activity Alerts on its pages in response to a business gaining public attention for their Covid health and safety practices. This has included if a business notified customers that vaccinations were required for its employees or for its patrons.

As a result, Yelp has had to remove nearly 4,500 reviews for violating its content guidelines.

Image Credits: Yelp

As Yelp was already handling these types of incidents, it’s now more formally introducing a way for businesses to flag their Covid policies through the new products.

The company notes it put a similar system in place when it launched our Black-owned attribute in June 2020 and again followed the same process for other identity attributes (e.g. Latinx-owned, Asian-owned, and LGBTQ-owned) by proactively monitoring business pages that activated these attributes for any hateful, racist or other harmful content that violated its content guidelines.

The company tells TechCrunch there was demand for its new Covid policy feature from business owners, as well.

Image Credits: Yelp

“Both business owners and consumers have expressed interest in Yelp releasing vaccine-related attributes,” said Noorie Malik, Yelp’s VP of User Operations. “For many months we’ve seen businesses implement vaccine requirements for both their customers and staff. As a result, we’ve also seen a rise in reviews focused on people’s stance on Covid vaccinations rather than their actual experience with the business,” Malik noted.

The businesses want to be assured that their page will be more actively monitored for false reviews when they choose to share this information.

Yelp, of course, understands that if allowed its reviews platform to become a place that veered away from customers detailing their first-hand experiences, it service overall would become less useful.

“Yelp has always served as a trusted source of information on local businesses, helping the millions of people that come to Yelp every day make informed spending decisions,” Malik said. “It’s important that consumers have a resource for relevant first-hand information when engaging with a business. You could argue this is even more important during a public health crisis, making reviews from relevant first-hand consumer experiences critical.”

The feature is rolling out now and can be found on the Yelp for Business account page.

More than half of the U.S. population has stayed away from considering life insurance because they believe it’s probably too expensive, and the most common way to buy it today is in person. A startup that’s built a platform that aims to break down those conventions and democratize the process by making life insurance (and the benefits of it) more accessible is today announcing significant funding to fuel its rapidly growing business.

Ethos, which uses more than 300,000 data points online to determine a person’s eligibility for life insurance policies, which are offered as either term or whole life packages starting at $8/month, has picked up $100 million from a single investor, SoftBank Vision Fund 2. Peter Colis, Ethos’s CEO and co-founder, said that the funding brings the startup’s valuation to over $2.7 billion.

This is a quick jump for the the company: it was only two months ago that Ethos picked up a $200 million equity round at a valuation of just over $2 billion.

It’s now raised $400 million to date and has amassed a very illustrious group of backers. In addition to SoftBank they include General Catalyst, Sequoia Capital; Accel; GV; Jay-Z’s Roc Nation; Glade Brook Capital Partners; Will Smith and Robert Downey Jr.

This latest injection of funding — which will be used to hire more people and continue to expand its product set into adjacent areas of insurance life critical illness coverage — was unsolicited, Colis said, but comes on the heels of very rapid growth.

Ethos — which is sold currently only in the U.S. across 49 states — has seen both revenues and user numbers grow by over 500% compared to a year ago, and it’s on track to issue some $20 billion in life insurance coverage this year. And it is approaching $100 million in annualized growth profit. Ethos itself is not yet profitable, Colis said.

There are a couple of trends going on that speak to a wide opportunity for Ethos at the moment.

The first of these is the current market climate: globally we are still battling the Covid-19 global health pandemic, and one impact of that — in particular given how Covid-19 has not spared any age group or demographic — has been more awareness of our mortality. That inevitably leads at least some part of the population to considering something like life insurance coverage that might not have thought about it previously.

However, Colis is a little skeptical on the lasting impact of that particular trend. “We saw an initial surge of demand in the Covid period, but then it regressed back to normal,” he said in an interview. Those who were more inclined to think about life insurance around Covid-19 might have come around to considering it regardless: it was being driven, he said, by those with pre-existing health conditions going into the pandemic.

That, interestingly, brings up the second trend, which goes beyond our present circumstances and Colis believes will have the more lasting impact.

While there have been a number of startups, and even incumbent providers, looking to rethink other areas of insurance such as car, health and property coverage, life insurance has been relatively untouched, especially in some markets like the U.S. Traditionally, someone taking out life insurance goes through a long vetting process, which is not all carried out online and can involve medical examinations and more, and yes, it can be expensive: the stereotype you might best know is that only wealthier people take out life insurance policies.

Much like companies in fintech who have rethought how loan applications (and payback terms) can be rethought and evaluated afresh using big data — pulling in a new range of information to form a picture of the applicant and the likelihood of default or not — Ethos is among the companies that is applying that same concept to a different problem. The end result is a much faster turnaround for applications, a considerably cheaper and more flexible offer (term life insurance lasts for only as long as a person pays for it to), and generally a lot more accessibility for everyone potentially interested. That pool of data is growing all the time.

“Every month, we get more intelligent,” said Colis.

There is also the matter of what Ethos is actually selling. The company itself is not an insurance provider but an “insuretech” — similar to how neobanks use APIs to integrate banking services that have been built by others, which they then wrap with their own customer service, personalization and more — Ethos integrates with third-party insurance underwriters, providing customer service, more efficient onboarding (no in-person medical exams for example) and personalization (both in packages and pricing) around them. Given how staid and hard it is to get more traditional policies, it’s essentially meant completely open water for Ethos in terms of finding and securing new customers.

Ethos’s rise comes at a time when we are seeing other startups approaching and rethinking life insurance also in the U.S. and further afield. Last week, YuLife in the UK raised a big round to further build out its own take on life insurance, which is to sell policies that are linked to an individual’s own health and wellness practices — the idea being that this will make you happier and give more reason to pay for a policy that otherwise feels like some dormant investment; but also that it could help you live longer (Sproutt is another also looking at how to emphasize the “life” aspect of life insurance). Others like  DeadHappy and BIMA are, like Ethos, rethinking accessibility of life insurance for a wider set of demographics.

There are some signs that Ethos is catching on with its mission to expand that pool, not just grow business among the kind of users who might have already been considering and would have taken out life insurance policies. The startup said that more than 40% of its new policy holders in the first half of 2021 had incomes of $60,000 or less, and nearly 40% of new policy holders were under the age of 40. The professions of those customers also speak to that democratization: the top five occupations, it said were homemaker, insurance agent, business owner, teacher, and registered nurse.

That traction is likely one reason why SoftBank came knocking.

“Ethos is leveraging data and its vertically integrated tech stack to fundamentally transform life insurance in the U.S.,” said Munish Varma, managing partner at SoftBank Investment Advisers, in a statement. “Through a fast and user-friendly online application process, the company can accurately underwrite and insure a broad segment of customers quickly. We are excited to partner with Peter Colis and the exceptional team at Ethos.”

Just as many other employee services have gone digital, so too is mental health. In the consumer space there are growing startups like Equoo, but the race is now on for the employee.

And since telemedicine has gone digital and video-based, so too is mental health provision. A number of companies are already playing in this space, including Spill Chat, On Mind, Lyra Health, Modern Health, Ginger and TalkSpace For Business.

Oliva’s take on this is not to create a marketplace or pre-recorded videos, but to put trained professionals in front of employees to talk directly to them. And there is even science to back it up. Indeed, some research suggests Psychotherapy via the internet is as good if not better than face-to-face consultations.

Oliva’s on-demand, professional-led mental healthcare for employees and managers has now attracted investment to the tune of a $2.2m pre-seed investment round, led by Moonfire Ventures, the new seed-stage VC firm from Atomico co-founder Mattias Ljungman.

The UK and Spain-based startup has also attracted angel investment from tech executives from Amazon, Booking.com, DogBuddy, Typeform, Hotjar, TravelPerk, and more.

Oliva is founded by Javier Suarez, who previously co-founded TravelPerk, and Sançar Sahin, who previously led marketing teams at Hotjar and Typeform, so both are well blooded in startups.

Suarez says he was inspired to create a mental health startup after the rigors of TravelPerk: “Employees are a company’s greatest asset – the better they feel, the better your company performs. But organizations are not set up to support their employees’ mental health in and outside of the workplace, which creates a massive problem for teammates, managers, and the organization as a whole. We’ve launched Oliva to give employees access to comprehensive online mental healthcare and to help organizations overcome the related challenges—from attracting & retaining talent and training managers to supporting remote workers.”

Privacy is addressed via the use of a secure and encrypted personal portal, where employees can chat with a care provider who matches them with a professional. They get 1-to-1 video therapy sessions from a range of mental health professionals, and can also track their progress. 

The team has also attracted Dr. Sarah Bateup, who has spent over two decades teaching and training mental healthcare professionals, who is now Chief Clinical Officer.

She said: “Oliva improves the way mental healthcare is accessed, supported, and paid for, while also adding more ongoing oversight and accountability to the process. Our ambition is for Oliva to be viewed as a badge of quality and set a new standard for workplace mental healthcare.”

Mattias Ljungman, Founder at Moonfire Ventures, added: “Mental health has been an overlooked area of care and wellbeing, especially in the workplace. Oliva’s founders are the only team we’ve seen taking a holistic, impact-driven approach to supporting mental health. While employer-funded mental health is becoming a well-established model in the US, Oliva is the first to bring a truly comprehensive approach to UK and European businesses.”

Oliva platform is integrated with Slack, providing employees with mental health drop-in sessions, therapy courses, and dedicated training and support for managers.

Another US femtech startup has joined the race to build up data-sets to support research into and understanding of a range of health issues that can affect women.

Evvy has today launched an at-home test kit for the vaginal microbiome. The user returns their swab to the startup for analysis — and gets detailed information and analysis of the microbes (fungi and bacteria) that are present in their vagina and may be associated with a variety of health concerns.

Users of the test also get personalized suggestions for things they could try (such as diet and lifestyle changes) to improve the balance of microbes — potentially helping with related heath issues they may be suffering from, like yeast infections or BV.

Variances in the microbes present in an individual’s vaginal microbiome are thought to have broad implications for women’s health — playing a role in relatively minor infections (like thrush) but Evvy also flags research linking imbalances in the vaginal microbiome to more serious issues like infertility or pre-term birth, or even linkages to the progression of cervical cancer.

Decoding the vaginal microbiome is thus seen as an opportunity to support a broad range of women’s health goals.

“We give users back a full understanding of everything that’s present. So here are all of the bacteria and fungi and importantly what is the relative amount of each of those bacteria,” explains CEO and co-founder Priyanka Jain, noting that users also get their test data in a downloadable format so they can take the information to their healthcare provider if they wish.

“There are certain bacteria that play really important roles in the vagina, either positive or negative, and understanding if that’s 90% of your vagina vs 5% makes a big difference… For every single microbe that we show to a woman we also fully explain what that microbe is, what the scientific understanding of it is today, how it might contribute to symptoms, how it might be behaving with other microbes that exist in your vagina — as well as if research has shown that it’s related to any health outcomes that you might care about.”

“We also give every woman a full personalized plan — that includes ways to help reduce any type of disruptive bacteria, ways to promote their protective bacteria and ways to overall maintain their vaginal health based on their personal life experiences,” she adds.

As with many such femtech startups, Evvy is targeting the women’s health data gap. This refers to how women can have a relatively poor experience of traditional healthcare, perhaps especially when seeking help or support with conditions related to female biology, because of historic under-representation of women in medical research — which means female health conditions tend to be less well researched and understood vs conditions affecting biological men.

Even relatively common conditions which can affect the vagina — such as a simple yeast infection — can be frustratingly difficult to connect to individual triggers. And while over-the-counter treatments do work, some women report recurrent infections — and may benefit from a better understanding of why the infections may be occurring in the first place.

The problem of less research into women’s health issues does also mean that femtech startups can have a lot of ground to cover to live up to enticing pitches of ‘demystifying’ the female body, as Evvy couches it. In its case, a key challenge is clearly analyzing the vaginal microbiome data it gets from users and turning it into useful recommendations for each person — without overpromising, given there may be relatively little research to back up possible links to wider health conditions.

Evvy says it tackles this challenge by signposting the level of research associated with each of the personalized suggestions it offers.

“I always say treat women like they’re smart,” says Jain. “What we actually do on each of our recommendations is we rate them. So they’re either rated as ‘novel’, ’emerging’ or ‘established’. And we show the women this is the research that exists on this type of treatment [and how relevant it might be to them personally — based on] if it was done on people that resemble you enough that you are actually interested in what the results are.

“Our goal is to highlight everything that’s out there. Because women are… looking for answers everywhere — and you see this kind of amazing crowdsourcing of knowledge, of people trying to figure out what might work for them — and our goal is to say, from a scientific perspective, this is everything that has been studied and we are actually just transparent about how well researched each of those things are.”

Jain says wider research-related goals include trying to identify biomarkers with suspected links to a swathe of serious female health issues — such as infertility, preterm birth, STI acquisition and cervical cancer progression.

Although it’s important to note that Evvy’s commercial offering comes with a disclaimer that it’s not providing medical advice — and is only selling a “wellness” test for now. This is because the service is not a regulated medical device. Hence Evvy specifies it’s only providing customers with “information” about their vaginal microbiome (although the co-founders told us they may consider applying for FDA clearance in the future).

The gap in knowledge around female health issues has led to a proliferation of ‘wellness’ claims and products targeted at women — some of which are, unfortunately, peddling what amounts to ‘snake oil’; i.e. selling products that lack rigorous scientific research to underpin a fuzzy range of ‘holistic benefits’ suggested by the associated marketing (crystal-healing yoni eggs, anyone?).

Being in the unregulated ‘wellness’ category therefore has risks for any femtech startup. But Evvy also sees an opportunity to cut through some of the noise and dubious claims by arming women with robust data on what’s going on in their bodies and connecting them with genuine scientific expertise that can help them interpret it.

Education is a key goal for the startup, per CMO Laine Bruzek.

“How can we bring the scientific community, care providers and women together in the same place to get their questions answered quickly and with the best scientific information… Education is just such an important goal for us because there’s not a lot of great information that exists on the Internet,” she says.

“Not just about your vaginal microbiome — which is sort of a new and emerging space — but just vaginal health in general. There’s so much misinformation, there’s so much snake oil that people are selling. So we want to make sure that we have, not just a chance to bring the women together, but that we give them access to people who are pushing the bounds of vaginal health research so that they can get the best information when they need it.”

Evvy’s approach — which includes bringing in OBGYNs and experts in gynecology & reproductive health as advisors (although the founders themselves have data science and product design backgrounds) — has attracted some top-tier investors: Today it’s announcing a $5 million seed round led by General Catalyst which will see the fund’s Margo Georgiadis (formerly the CEO of Ancestry.com) join the board.

Commenting in a statement, Georgiadis said: “Evvy is breaking boundaries to advance women’s health with more affordable and comprehensive testing starting with its vaginal microbiome metagenomics test. The team has bold plans to enable greater early detection, improved treatment, and enhanced therapeutics using new female-specific biomarkers.”

“There is a huge opportunity to build new datasets that will transform our understanding of these conditions in the female body, and I truly believe that Evvy’s unique platform combined with the development of new therapeutics will catalyze a new era in women’s health,” added Dr. Craig Cohen, professor of obstetrics, gynecology & reproductive sciences at UCSF and advisor to Evvy in another supporting statement.

Evvy is not the first startup to sell a home testing kit for the vaginal microbiome, targeting women who may be suffering from conditions related to microbial imbalances, or — well — just women who want to learn more about their own bodies.

Juno Bio, for example, launched an at-home test kit last year.

But Evvy is using a technique — called metagenomic sequencing — which the founders say is able to capture more data than other commercial tests, or the typical tests a woman is able to obtain via a doctor’s office (where scans may only look for a few specific pathogens). So the pitch is the approach provides a higher fidelity view of what’s going on inside a woman’s vagina.

“A lot of the work that we’ve done is specifically incorporating what’s called metagenomic sequencing into the analysis of the vaginal microbiome,” explains Jain. “When you go to the doctor’s office the type of test that they can run is what’s called a PCR test — essentially they take a sample and they look for a specific pathogen within that sample. So oftentimes when you go to the doctor you’ll get a PCR test that looks for one to three different individuals pathogens.

“Since then there have been a few iterations of improvements on that done by other companies. Some are not using what’s called 16-S sequencing — which is a form of amplicon sequencing — which is definitely a large step up from PCR but the downside is it’s only able to look at certain variable regions of the genome. And you actually have to pre-define what you’re looking for. So it’s much harder to do discovery and you’re not able to find all bacteria and fungi that are present. Because 16-S actually can’t detect fungi at all so you have to separately test for it — which means you can’t understand their relative relationships.

“So our test is really the first time anyone is using metagenomics at scale to better understand the vaginal microbiome; both for individual woman and the healthcare system as a whole… In the same way that 16-S was an improvement on PCR, metagenomics is just an improvement on 16-S; it allows us to understand everything that’s possibly present across all bacteria and fungi.”

Per Jain, the service is the only commercially available vaginal microbiome test that’s able to use metagenomics.

A key part of Evvy’s work as a startup is then the analysis of this higher dimension data it’s capturing — to map different microbes to potential health outcomes (based on its analysis of existing research) — and understand how to interpret individual findings and offer relevant and actionable information to each user.

“A lot of our work has been on the data analysis part,” confirms Jain. “So when you do metagenomics sequencing you get much, much higher fidelity data back — and we had to build out everything from, we co-developed an amazing bioinformatics pipeline that is able to analyze that type of data and understand which bacteria and fungi they are. And then actually mapped out for each of those bacteria and fungi how are they related to the vaginal microbiome? What type of symptoms might they cause, and also what type of health implications might they be related to.

“Lastly we’ve done a tonne of work with our science advisory board around putting together personalized recommendations that take into account — not only the microbial data that we get from the test — but also someone’s health history and their symptoms, and if what stage of menopause they’re in, or all of this other information so that we can actually make this information actionable for the women.”

Once data from paying users starts to flow the idea is also to support a range of Evvy’s own research initiatives and partnerships (on the latter, specific details are being kept under wraps for now) — all aimed at furthering knowledge of women’s health and supporting what they hope will be more products in future.

“There’s been so much research done showing that the vaginal microbiome is for example related to pre-term birth,” says Jain. “When you look at women who deliver early or pre-term, they tend to have very different vaginal microbiomes than women who don’t. But a lot of the sequencing that’s been done in that space has been using things like 16-S — and our goal is to bring a much higher level of fidelity. And so, more specifically, we can look at the strain level of bacteria — whereas 16-S and other forms of sequencing can only get you to the species level. And when we’re looking at something as complex as pre-term birth, cervical cancer progression and STI acquisition it’s not just what’s there — but it’s getting to the very, very high fidelity information of specifically what strains are there. So that we can actually start to discover what are the biomarkers that might be leading to differences between people who deliver pre-term and people who don’t.”

“The other value of metagenomic sequencing is it gives us functional profiling,” she adds. “Which helps us not only understand who’s there but also what they might be doing — and all of that information together is more likely able to help us better understand these complex conditions that research has shown is related but no-one’s been able to figure out exactly how.”

While the overarching goal is that data from users’ vaginal swab samples will support research into a range of women’s health issues, Evvy’s users are also paying for a commercial service to get their individual analysis — so what can they expect?

The at-home swab test kit is being priced at $129 for one test kit — which delivers them with a personalized analysis after two weeks.

Evvy is also offering a membership rate for users who want to be able to carry out multiple tests — to be able to track changes to their vaginal microbiome — and for those users tests will cost $99 each (with the user able to take a test every three months).

As they launch the service across the US’ 20 states, Evvy’s co-founders say they’re hoping “thousands” of women will sign up to quantify their vaginal microbiome and support the wider goal of backing research into female health.

“Why is it that looking at the bacteria in the vaginal microbiome is 94% accurate in predicting whether or not a cycle of IVF works?” asks Jain. “Why is it that women who give birth pre-term have a differing vaginal microbiome than people who don’t? Or the whole cervical cancer progression, STI acquisition, pelvic inflammatory disease.

“There’s so many conditions that seem to be — either the vaginal microbiome is an interesting diagnostic opportunity [or] there’s even some very early research showing that women who have PCOS [polycystic ovary syndrome] or endometriosis have varying markers in their vaginal microbiome from women who don’t have those conditions — so everything from helping to detect disease to helping diagnose things, to helping predict risk for so many of these conditions that often we don’t catch for too long.

“Also thinking about treatment as well — something like IVF success or pre-term birth — if we’re able to identify risk earlier can we actually come up with interventions that are personalized to that individual person so that we’re able to avoid that negative outcome in the long term?”

Life insurance — financial protection you buy against your death — may not read like the liveliest of industries on paper. But a life insurance startup that believes it can turn that stigma around, by infusing the concept with gamification and a push towards wellness and health — and change the life insurance industry in the process — is today announcing significant funding, a sign of the traction it’s getting for its big ideas.

YuLife, a London startup that has built a new kind of life insurance concept — it incentivizes and rewards users to focus on their physical and mental health through a gamified interface — has raised $70 million in what is, to date, one of the largest Series B’s raised by an insurtech startup in Europe.

Led by Target Global, the round also included Eurazeo, Latitude and previous backers Creandum, Notion Capital, Anthemis, MMC Ventures, and OurCrowd. Sammy Rubin, YuLife’s CEO and founder, confirmed that the round values YuLife at $346 million (£250 million).

The company will be using the funding to continue expanding its business, build more products on its platform, and importantly continue to invest in the technology that it uses to run its service and determine how its policies should run.

“Our insurance is about helping people live healthier and longer lives,” Rubin said in an interview. “If we can help to reduce claims while incentivizing people to do that, it’s a win-win.” But it’s about more than that, he added. “We are building a new type of risk model where we are able to create new actuarial tables, which have not been updated in 200 years. Actually, I think smoker rates and how they’ve changed was the last update. So, most will just look at your age and whether you are a smoker and that’s it.”

YuLife is currently active only in the UK and is only sold directly to organizations, who in turn provide it to their employees. That business currently — which also includes income protection and critical illness cover — provides $15 billion of coverage and has seen 10x growth in the last year — a bumper one for life insurance policies, possibly for the worst reasons (hello, pandemic; goodbye, predicting what the future might look like). Customers include Capital One, Co-op, Curve, Havas Media, Severn Trent, and Sodexo.

That $15 billion is just a drop in the bucket in an industry that is currently estimated to be worth some $2.2 trillion.

The company got its start on the back of a persistent problem that Rubin experienced at his previous insurance startup PruProtect (which is now called Vitality Life): “Usually insurance benefits just sit on shelf and never get used,” he said. YuLife set out to change that by making the policy “all about engagement.”

The app — built by veterans of the gaming industry — is designed around the concept of different environments, currently covering forest, ocean, desert and mountains, which YuLife collectively terms its “Yuniverse.” (This incidentally also became a template for the company’s HQ design in London.)

Within each of these environments, users are encouraged to walk, cycle, meditate and do other activities to get around their environments in a healthy way, while at the same time being able to compare their progress against other co-workers. There is a degree of personalization in everyone’s experience, in that one person leaning into one activity over another seems to produce different subsequent scenarios.

Along with this, users are offered discounts on third-party products to further engage with the game within YuLife, which could include a subscription to meditation app Calm, FitBit and Garmin devices, and more.

As users make their ways through their worlds, they get rewards, in the form of something called YuCoins. The YuCoins can in turn be used to redeem vouchers from the likes of Amazon and Asos to buy things… consumerism being another way to improve happiness for some of us.

All of this sums up as more than just a policy aimed at giving people peace of mind for their families should they depart this world.

“Long term, it’s not just about health, it’s about lifestyle,” Rubin said. It’s also about YuLife’s business: the various products that it offers are built around an affiliate model, so there is a business interest for the company around offering and seeing items purchased and redeemed. However, this is not essential to using the app as a policy holder. The win-win theme runs strong, but so too does the fact that YuLife is taking a different approach altogether, in an industry where a lot of the “disruption” has up to now been more about how to buy life insurance, rather than reassessing what life insurance actually is. (For others in the space, see DeadHappy, BIMA, and the Jay-Z backed Ethos.)

“YuLife is redefining life insurance, using the most innovative technologies to transform a largely traditional industry,” said Ben Kaminski, partner, Target Global, in a statement. “With health and wellbeing increasingly thrust into the limelight in the wake of Covid-19, YuLife is fundamentally changing insurance by incentivizing people to lead healthier lifestyles. YuLife is ideally positioned to build on its tenfold growth during the pandemic and lead the way in helping its clients respond to the challenges posed by an ever-changing working environment. We are very proud to partner with YuLife on its journey of becoming a global leader in life insurance.”

Hello and welcome back to Equity, TechCrunch’s venture capital-focused podcast, where we unpack the numbers behind the headlines.

For this week’s deep dive, Alex and Natasha and Danny decided that it was time to talk about drugs. No, not like drugs for fun, but instead drugs that you might have considered fun, but are now being redirected to help bolster your health.

Yep, that’s our theme today. As it turns out, there are a number of startups and even nascently public companies that are pursing using drugs that we might consider recreational for serious health purposes. Which is neat, as our habit of decrying any drug that makes you feel better as immoral has likely held us back from learning quite a lot about them.

• Venture capital investment in psychedelic start-ups, per CB Insights, rose from sub-$100 million results in 2018 and 2019 to $346 million last year.
• Vice clauses, however, can pause a legitimate issue for investors who might want to cut a check in the space.
• From the startup angle, NUE Life Health recently raised $3.3 million, and Osmind is up to some neat stuff regarding mental health.
• From the public markets, Atai Life Sciences, Compass Pathways, and MindMed are the companies worth watching.

Frankly this was a fun one to record, even if the topic at hand is actually rather serious. Chat Friday morning!