Personalized nutrition startup Zoe — named not for a person but after the Greek word for ‘life’ — has topped up its Series B round with $20M, bringing the total raised to $53M.

The latest close of the B round was led by Ahren Innovation Capital, which the startup notes counts two Nobel laureates as science partners. Also participating are two former American football players, Eli Manning and Ositadimma “Osi” Umenyiora; Boston, US-based seed fund Accomplice; healthcare-focused VC firm THVC and early stage European VC, Daphni.

The U.K.- and U.S.-based startup was founded back in 2017 but operated in stealth mode for three years, while it was conducting research into the microbiome — working with scientists from Massachusetts General Hospital, Stanford Medicine, Harvard T.H. Chan School of Public Health, and King’s College London.

One of the founders, professor Tim Spector of King’s College — who is also the author of a number of popular science books focused on food — became interested in the role of food (generally) and the microbiome (in particular) on overall health after spending decades researching twins to try to understand the role of genetics (nature) vs nurture (environmental and lifestyle factors) on human health.

Zoe used data from two large-scale microbiome studies to build its first algorithm which it began commercializing last September — launching its first product into the U.S. market: A home testing kit that enables program participants to learn how their body responds to different foods and get personalized nutrition advice.

The program costs around $360 (which Zoe takes in six instalments) and requires participants to (self) administer a number of tests so that it can analyze their biology, gleaning information about their metabolic and gut health by looking at changes in blood lipids, blood sugar levels and the types of bacteria in their gut.

Zoe uses big data and machine learning to come up with predictive insights on how people will respond to different foods so that it can offer individuals guided advice on what and how to eat, with the goal of improving gut health and reducing inflammatory responses caused by diet.

The combination of biological responses it analyzes sets it apart from other personalized nutrition startups with products focused on measuring one element (such as blood sugar) — is the claim.

But, to be clear, Zoe’s first product is not a regulated medical device — and its FAQ clearly states that it does not offer medical diagnosis or treatment for specific conditions. Instead it says only that it’s “a tool that is meant for general wellness purposes only”. So — for now — users have to take it on trust that the nutrition advice it dishes up is actually helpful for them.

The field of scientific research into the microbiome is undoubtedly early — Zoe’s co-founder states that very clearly when we talk — so there’s a strong component here, as is often the case when startups seek to use data and AI to generate valuable personalized predictions, whereby early adopters are helping to further Zoe’s research by contributing their data. Potentially ahead of the sought for individual efficacy, given so much is still unknown around how what we eat affects our health.

For those willing to take a punt (and pay up), they get an individual report detailing their biological responses to specific foods that compares them to thousands of others. The startup also provides them with individualized ‘Zoe’ scores for specific foods in order to support meal planning that’s touted as healthier for them.

“Reduce your dietary inflammation and improve gut health with a 4 week plan tailored to your unique biology and life,” runs the blurb on Zoe’s website. “Built around your food scores, our app will teach you how to make smart swaps, week by week.”

The marketing also claims no food is “off limits” — implying there’s a difference between Zoe’s custom food scores and (weight-loss focused) diets that perhaps require people to cut out a food group (or groups) entirely.

“Our aim is to empower you with the information and tools you need to make the best decisions for your body,” is Zoe’s smooth claim.

The underlying premise is that each person’s biology responds differently to different foods. Or, to put it another way, while we all most likely know at least one person who stays rake-thin and (seemingly) healthy regardless of what (or even how much) they eat, if we ate the same diet we’d probably expect much less pleasing results.

“What we’re able to start scientifically putting some evidence behind is something that people have talked about for a long time,” says co-founder George Hadjigeorgiou. “It’s early [for scientific research into the microbiome] but we have shown now to the world that even twins have different gut microbiomes, we can change our gut microbiomes through diet, lifestyle and how we live — and also that there are associations around particular [gut] bacteria and foods and a way to improve them which people can actually do through our product.”

Users of Zoe’s first product need to be willing (and able) to get pretty involved with their own biology — collecting stool samples, performing finger prick tests and wearing a blood glucose monitor to feed in data so it can analyze how their body responds to different foods and offer up personalized nutrition advice.

Another component of its study of biological responses to food has involved thousands of people eating “special scientific muffins”, which it makes to standardized recipes, so it can benchmark and compare nutritional responses to a particular blend of calories, carbohydrate, fat, and protein.

While eating muffins for science sounds pretty fine, the level of intervention required to make use of Zoe’s first at-home test kit product is unlikely to appeal to those with only a casual interest in improving their nutrition.

Hadjigeorgiou readily agrees the program, as it is now, is for those with a particular problem to solve that can be linked to diet/nutrition (whether obesity, high cholesterol or a disease like type 2 diabetes, and so on). But he says Zoe’s goal is to be able to open up access to personalized nutrition advice much more widely as it keeps gathering more data and insights.

“The idea is, as always, we start with a focused set of people with problems to solve who we believe will have a life-changing experience,” he tells TechCrunch. “At this point we are not trying to create a product for everyone — and we understand that that has limitations in terms of how much we scale in the beginning. Although even still within this focused group of people I can assure you there’s tonnes of people!

“But absolutely the whole idea is that after we get a first [set of users]… then with more data and with more experience we can simplify and start making this simpler and more accessible — both in terms of its simplicity and also it’s price. So more and more people. Because at the end of the day everyone has this right to be able to optimize and understand and be in control — and we want to make that available to everyone.

“Regardless of background and regardless of socio-economic status. And, in fact, many of the people who have the biggest problems around health etc are the ones who have maybe less means and ability to do that.”

Zoe isn’t disclosing how many early users it’s onboarded so far but Hadjigeorgiou says demand is high (it’s currently operating a wait-list for new sign ups).

He also touts promising early results from interim trial with its first users — saying participants experienced more energy (90%), felt less hunger (80%) and lost an average of 11 pounds after three months of following their AI-aided, personalized nutrition plan. Albeit, without data on how many people are involved in the trials it’s not possible to quantify the value of those metrics.

The extra Series B funding will be used to accelerate the rollout of availability of the program, with a U.K. launch planned for this year — and other geographies on the cards for 2022. Spending will also go on continued recruitment in engineering and science, it says.

Zoe already grabbed some eyeballs last year, as the coronavirus pandemic hit the West, when it launched a COVID-19 symptom self-reporting app. It has used that data to help scientists and policy makers understand how the virus affects people.

The Zoe COVID-19 app has had some 5M users over the last year, per Hadjigeorgiou — who points to that (not-for-profit) effort as an example of the kind of transformative intervention the company hopes to drive in the nutrition space down the line.

“Overnight we got millions and millions of people contributing to help uncover new insights around science around COVID-19,” he says, highlighting that it’s been able to publish a number of research papers based on data contributed by app users. “For example the lack of smell and taste… was something that we first [were able to prove] scientifically, and then it became — because of that — an official symptom in the list of the government in the U.K.

“So that was a great example how through the participation of people — in a very, very fast way, which we couldn’t predict when we launched it — we managed to have a big impact.”

Returning to diet, aren’t there some pretty simple ‘rules of thumb’ that anyone can apply to eat more healthily — i.e. without the need to shell out for a bespoke nutrition plan? Basic stuff like eat your greens, avoid processed foods and cut down (or out) sugar?

“There are definitely rules of thumb,” Hadjigeorgiou agrees. “We’ll be crazy to say they’re not. I think it all comes back to the point that although there are rules of thumb and over time — and also through our research, for example — they can become better, the fact of the matter is that most people are becoming less and less healthy. And the fact of the matter is that life is messy and people do not eat even according to these rules of thumb so I think part of the challenge is… [to] educate and empower people for their messy lives and their lifestyle to actually make better choices and apply them in a way that’s sustainable and motivating so they can be healthier.

“And that’s what we’re finding with our customers. We are helping them to make these choices in an empowering way — they don’t need to count calories, they don’t need to restrict themselves through a Keto [diet] regime or something like that. We basically empower them to understand this is the impact food has on your body — real time, how your blood sugar levels change, how your bacteria change, how your blood fat levels changes. And through that empowerment through insight then we say hey, now we’ll give you this course, it’s very simple, it’s like a game — and we’ll given you all these tools to combine different foods, make foods work for you. No food is off limits — but try to eat most days a 75 score [based on the food points Zoe’s app assigns].

“In that very empowering way we see people get very excited, they see a fun game that is also impacting their gut and metabolism and they start feeling these amazing effects — in terms of less hunger, more energy, losing weight and over time as well evolving their health. That’s why they say it’s life changing as well.”

Gamifying research for the goal of a greater good? To the average person that surely sounds more appetitizing than ‘eat your greens’.

Though, as Hadjigeorgiou concedes, research in the field of microbiome — where Zoe’s commercial interests and research USP lie — is “early”. Which means that gathering more data to do more research will remain a key component of the business for the foreseeable future. And with so much still to be understood about the complex interactions between food, exercise and other lifestyle factors and human health, the mission is indeed massive.

In the meanwhile, Zoe will be taking it one suggestive nudge at a time.

“Sugar is bad, kale’s great but the whole kind of magic happens in the middle,” Hadjigeorgiou goes on. “Is oatmeal good for you? Is rice good for you? Is wholewheat pasta good for you? How do you combine wholewheat pasta and butter? How much do you have? This is where basically most of our life happens.

“Because people don’t eat ice-cream the whole day and people don’t eat kale the whole day. They eat all these other foods in the middle and that’s where the magic is — knowing how much to have, how to combine them to make it better, how to combine it with exercise to make it better? How to eat a food that doesn’t dip your sugar levels three hours after you eat it which causes hunger for you. Theses are all the things we’re able to predict and present in a simple and compelling way through a score system to people — and in turn help them [understand their] metabolic response to food.”

The last year of pandemic living has been real-world, and sometimes harrowing, proof of how important it can be to have efficient and well-equipped emergency response services in place. They can help people remotely if need be, and when they cannot, they make sure that in-person help can be dispatched quickly in medical and other situations. Today, a company that’s building cloud-based tools to help with this process is announcing a round of funding as it continues to grow.

RapidDeploy, which provides computer-aided dispatch technology as a cloud-based service for 911 centers, has closed a round of $29 million, a Series B round of funding that will be used both to grow its business, and to continue expanding the SaaS tools that it provides to its customers. In the startup’s point of view, the cloud is essential to running emergency response in the most efficient manner.

“911 response would have been called out on a walkie talkie in the early days,” said Steve Raucher, the co-founder and CEO of RapidDeploy, in an interview. “Now the cloud has become the nexus of signals.”

Washington, DC-based RapidDeploy provides data and analytics to 911 centers — the critical link between people calling for help and connecting those calls with the nearest medical, police or fire assistance — and today it has about 700 customers using its RadiusPlus, Eclipse Analytics and Nimbus CAD products.

That works out to about 10% of all 911 centers in the US (7,000 in total), and covering 35% of the population (there are more centers in cities and other dense areas). Its footprint includes state coverage in Arizona, California, and Kansas. It also has operations in South Africa, where it was originally founded.

The funding is coming from an interesting mix of financial and strategic investors. Led by Morpheus Ventures, the round also had participation from GreatPoint Ventures, Ericsson Ventures, Samsung Next Ventures, Tao Capital Partners, Tau Ventures, among others. It looks like the company had raised about $30 million before this latest round, according to PitchBook data. Valuation is not being disclosed.

Ericsson and Samsung, as major players in the communication industry, have a big stake in seeing through what will be the next generation of communications technology and how it is used for critical services. (And indeed, one of the big leaders in legacy and current 911 communications is Motorola, a would-be competitor of both.) AT&T is also a strategic go-to-market (distribution and sales) partner of RapidDeploy’s, and it also has integrations with Apple, Google, Microsoft, and OnStar to feed data into its system.

The business of emergency response technology is a fragmented market. Raucher describes them as “mom-and-pop” businesses, with some 80% of them occupying four seats or less (a testament to the fact that a lot of the US is actually significantly less urban than its outsized cities might have you think it is), and in many cases a lot of these are operating on legacy equipment.

However, in the US in the last several years — buffered by innovations like the Jedi project and FirstNet, a next-generation public safety network — things have been shifting. RapidDeploy’s technology sits alongside (and in some areas competes with) companies like Carbyne and RapidSOS, which have been tapping into the innovations of cell phone technology both to help pinpoint people and improve how to help them.

RapidDeploy’s tech is based around its RadiusPlus mapping platform, which uses data from smart phones, vehicles, home security systems and other connected devices and channels it to its data stream, which can help a center determine not just location but potentially other aspects of the condition of the caller. Its Eclipse Analytics services, meanwhile, are meant to act as a kind of assistant to those centers to help triage situations and provide insights into how to respond. The Nimbus CAD then helps figure out who to call out and routing for response. 

Longer term, the plan will be to leverage cloud architecture to bring in new data sources and ways of communicating between callers, centers and emergency care providers.

“It’s about being more of a triage service rather than a message switch,” Raucher said. “As we see it, the platform will evolve with customers’ needs. Tactical mapping ultimately is not big enough to cover this. We’re thinking about unified communications.” Indeed, that is the direction that many of these services seem to be going, which can only be a good thing for us consumers.

“The future of emergency services is in data, which creates a faster, more responsive 9-1-1 center,” said Mark Dyne, Founding Partner at Morpheus Ventures, in a statement. “We believe that the platform RapidDeploy has built provides the necessary breadth of capabilities that make the dream of Next-Gen 9-1-1 service a reality for rural and metropolitan communities across the nation and are excited to be investing in this future with Steve and his team.” Dyne has joined the RapidDeploy board with this round.

New York headquartered Kaia Health, which offers AI-assisted digital therapies via a mobile app for chronic pain related to musculoskeletal (MSK) disorders and for Chronic Obstructive Pulmonary Disease (COPD), has raised a $75 million Series C.

The round was led by an unnamed leading growth equity fund with support from existing investors, including Optum Ventures, Eurazeo, 3VC, Balderton Capital, Heartcore Capital, Symphony Ventures (golfer Rory McIlroy’s investment vehicle), and A Round Capital.

The funding fast-follows a $26M Series B closed last summer. The pandemic has accelerated the uptake of telemedicine, generally — and Kaia has, unsurprisingly, seen a particular surge of interest in its virtual treatments.

After all, DIY home working set-ups are unlikely to have done much good for the average information worker’s back in the pandemic-struck year. Kaia’s real-time feedback generating motion coach is also able to offer treatment for neck, hip, knee, shoulder, hand/wrist, and foot/ankle pain.

A digital health solution may have been the only lockdown-friendly option for treating conditions considered ‘elective care’ during COVID-19 — meaning suffers of chronic pain may have faced restrictions on accessing physical healthcare provision like in-person physiotherapy. Kaia says it grew its business book 600% in 2020.

Given the U.S. healthcare sales cycle is heavily focused on January onboarding of new medical benefits by employers — who are key customers for Kaia in the market, where it now has around 50 employer and health plan clients — it’s expecting another big onboarding bump next January. And while it hadn’t been looking to raise again so soon after the Series B, doing so was “a very easy process”, says co-founder and CEO Konstantin Mehl.

“We actually planned to start the raise in the end of this year and then the pandemic happened and of course we had a huge boost because the healthcare system was pretty much shut down for in person elected treatments and chronic diseases are considered to be elected treatments which I think is a bit of a mistake.

“The thing is that the big b2b partners they are really scared that they will have this big backlog of surgical interventions that are very expensive… Pre-pandemic I think 20% of employers in the US were even interested in offering a digital therapy and then that changed to 100% immediately. So that was a big boost,” he goes on. “The other thing is that our market got really hot. We don’t really need the money right now but we met these investors and it was a very easy process.”

Kaia says that globally its digital MSK platform is accessible to 60M patients — which it claims makes it by far the biggest player in the space in terms of covered lives. (Other startups in the space include Hinge Health and Sword Health which are both also focused on MSK; and Physera, a virtual physical therapy provider that was acquired by Omada last year.)

The plan for Kaia’s (unexpectedly rapid) funding boost is “to be much more aggressive in building out our commercial team”, Mehl tells TechCrunch. “We are very proud of being a product focused company but it also gets a bit stupid at the point where you just need to bring the product in front of the relevant customer so we are investing a lot in that and also in computer vision because it’s still our USP.”

Kaia’s digital therapies rely on using computer vision to digitize proven treatments so they can be delivered outside traditional healthcare environments, with the app helping patients perform exercises correctly by themselves.

The user only needs a smartphone or tablet with a camera for the app to do real-time, posture-tracking and provide feedback. No wearables are required. Although Kaia is researching how 3D data from depth-sensing cameras which are now being embedded in higher end mobile devices may further feed the accuracy of its body tracking models.

“We basically can have the same correction functionality in your home that you have can have with a PT [personal trainer],” says Mehl. “We want to invest a lot more in computer vision and build out that team so we can also do that more aggressively now [with the Series C funding] which is cool.”

Kaia has started to use motion-tracking in another way in its patient-facing chronic pain app — as a way to track progress. So as well as asking patients to quantify their pain (which is a subjective measure) it can have an objective biomarker alongside patients’ pain assessments by getting them to do regular tests that track their body movements.

“We started to use motion-tracking besides the correction-tracking functionality also as a biomarker. So we basically can measure your body functionality. Now we can, for example, see which body parts are less flexible and that’s how we can measure the disease progression, instead of asking you how is the pain level today,” he explains. “Pain is the number one cause for work disability and the reason is because your body functionality decreases so if we can measure that correctly then we can also escalate it to the right speciality doctor, for example.”

Kaia can also quantify the progress of COPD patients in a similar way — by tracking them performing a sit-down, stand-up test.

Care for COPD has had a particular imperative during the pandemic as people with the chronic inflammatory lung disease who catch COVID-19 have the highest mortality rate among COVID-19-infected patients, per Mehl.

At the same time, pulmonary rehabilitation centers have been shut down during the pandemic because of the risk of infection to patients. So, once again, Kaia’s app has provided an alternative for suffers of chronic conditions to continue their rehab at home.

In the US Kaia focuses on activation rate as a percentage of the employer population — and Mehl says this stands between 5%-10%, depending on how the app is communicated to potential users. “We also had a company that had 15% of their population active it one year but you always have these outliers,” he adds.

Looking ahead to the coming 12 months, he says he expects to be able to grow revenue 5x-10x as a number of bigger partnerships kick in.

In Germany, where Kaia plans to start prescribing its app (via doctors), he’s hopeful they’ll be able to get 10,000 prescriptions done over the same period, once it has approval to do so under a national reimbursement system.

Plugging Kaia into wider healthcare provision

Integrating into a wider care pathway by being able to loop in healthcare providers where appropriate has been a big recent focus for Kaia.

In February it kicked off a major integration of its patient-facing MSK therapy/pain-management app with a referral system that plugs into services offered by other healthcare providers — using an escalation algorithm and screening and triage system, which it calls Kaia Gateway — to identify patients at risk of needing more invasive or intense treatment than the digital therapies its app can provide. It’s working with a number of premium partners for this referral path (i.e. within an employer or health plan’s ecosystem).

Its partners can provide additional medical services to relevant patients, both general and specialty care solutions, including disease management programs, PT, telemedicine, care navigation, and expert medical opinion services. Partners also get access to detailed treatment history on referred patients from Kaia, including via APIs.

“Besides being just an app-based therapy we want to expand more down the treatment path,” explains Mehl. “And also work with external medical providers — doctors etc — and bring our users at the right point to the right doctor to prevent any deterioration in pain that we cannot treat in the app. I think that brings a lot of trust, also, to the app.

“Because I think what’s happening now is that there’s so many digital therapies popping up everywhere. And one thing that is happening in the beginning when you’re small, like us three years ago, we just offered this app and said we don’t really know what’s happening before or after… Now we really want to integrate.”

“We have some cool partnerships coming up in the U.S. — partner with bigger medical providers that have thousands of medical providers on their payroll,” he goes on. “And then integrate with them so we can optimize the full treatment path. Because then the patients can really feel safe and say hey they don’t keep me in the app-based therapy when they know I should actually see somebody else because it’s not the best care anymore.”

“We have this platform approach but then we saw now it really makes sense to go deeper in these two diseases,” Mehl adds. “We start with our chronic pain approach in the U.S. and say we really want to go down the treatment path. And because the main problem is if people then start to be frustrated in our app and say I need something else and then they get back to this, for example, pain killers, opioids, surgery, cycle, and then they’re back in the system where we actually wanted to help them getting out of it so that’s why we say it’s not really possible to not integrate with healthcare professionals.

“You need to integrate them. If not you cannot always offer best care and then the patients realize at one point this app is not enough — but I also don’t get directed to a medical professional who could offer a new diagnosis or a different prescription. And then your trust is lost.”

“The other point is when you think about different levels of chronification, because we’re so scalable we can catch people much earlier in their chronification journey when the disease is still reversible. And even if our app is still the best treatment it helps to get an additional medical professional involvement to validate a diagnosis — or to just talk with a patient so that they really know that they’re safe here. So just reassuring, motivation and also diagnosis, to really say okay just to be sure we should make this diagnosis just to be sure you are getting best care. So I think that’s a huge product task and operational task for us.”

Kaia is starting by doing case referrals manually in-house — by setting up a medical case review team, staffed by doctors and therapies it employs — aided by a triage system that automatically flags patients for the team to review. But Mehl hopes this process will be increasingly assisted by AI.

“We assume yellow flags from what they told us in the entry test or from their exercise feedback or therapy feedback. Or from the interactions they have with their motivational coaches,” he explains of how the case review system works now. “Then [the case review team] has a look at them and decides if they should see an external medical provider partner and at what time.”

“Over time this should get more and more automated,” he adds. “We hope that we can make this better and better with machine learning over time and show that we can optimize the treatment path much better than just having this manual oversight. And that’s a huge challenge. If you think about what you need to do to get there I think it will define our product roadmap for years… But that’s also where the most value is to increase the quality of care. If not you just have siloed solutions everywhere… and the patient suffers because the treatment path is torn apart and it doesn’t feel like one thing.

“We will always need this clinical oversight. But where we can use machine learning is to help these medical professionals to look at the right patients at the right time. Because they cannot look at everybody all the time so there needs to be some filtering. And I think that filtering — or that triage — that can be really done by machine learning.”

Would Kaia ever consider becoming a healthcare provider itself? Combining a telemedicine service with some digitally delivered treatments is something that Sweden’s Kry, for example, has done — launching online cognitive behavioral therapy (CBT) treatments in its home market back in 2018 while also offering a telehealth platform and running a full healthcare service in some markets.

Mehl suggests not, arguing that telemedicine companies are by necessity generalists, since they are catering to “the top of the funnel”, handling and filtering patients with all sorts of complaints — which he says makes them less suited to focus deeply on catering to specific disease.

While, for Kaia, it’s deeply focused on building tech to treat a few specific diseases — and so, likewise, isn’t best suited to general medical service delivery. Partnering with medical service providers is therefore the obvious choice.

“I think about the patient journey and for the telemedicine companies… they might have some treatment paths integrated but they’re never as good as completely owning one chronic disease as we can be,” he says. “Most of chronic disease patients they just want to start a treatment because they talked with so many doctors. They want to find something that helps them and then at the right moment talk to the right medical professional. So that’s a difference in how telemedicine companies are doing it.

“The other question is how much of the medical provider job of the treatment path do we want to internalize? And we really are a tech company. We’re not very keen on becoming a medical provider. And we see that there are so many amazing medical providers in the landscape here — in different countries — that during COVID-19 had to become more digital, so it’s easy to partner with them, and why would we want to learn how to run a hospital where there are all these people who did it for decades and are really good at it, and we are really good at tech.”

“It’s really cool for the patient in the end. They know they get the best of both worlds and it’s optimized and ideally these offline medical providers get data from us so they can make better decisions — so they can also have a higher quality of decision-making because they have more data than just talking with a patient for two minutes. They can see our complete dashboard and how the patient progressed over time and everything — so the quality of decision-making gets higher.”

The U.S. overtook Europe as Kaia’s biggest market in recent years so it’s inexorably been focusing a lot of energy on serving its growing number of U.S. customers. The size of the addressable market in the U.S. is also massive, with ~100M chronic pain patients in the country, or around a third of the population.

But Kaia continues to develop its proposition in a number of European markets, including Germany which was where the business started. Mehl says its team in Munich is looking at how to make a recent reimbursement law for app-based health treatments will work for it in practice. It hasn’t yet obtained the necessary reimbursement code for doctors there to start prescribing its tech to their patients but it’s taking steps to change that.

At the same time, Mehl concedes that learning how to make doctors want to prescribe its app is an “open challenge” in the market.

“Some startups started doing it but — at scale — I still think there have to be some learning to be made to really scale it up,” he says of the German app prescriptions, adding that it’s preparing to hand in its application in relation to its COPD app which it will be bringing to market in Europe with a pharma partner.

“We also closed a partnership with a pharma company for Germany, UK and France to distribute our app through the pulmonologists — which is pretty cool. So we’re launching that partnership now,” he adds. “That will be exciting to see where the prescriptions start.”

Mehl professes himself a fan of Germany’s approach to digital healthcare — saying that it makes it easy to obtain a general reimbursement code which then gives the app-maker a year to prove any cost savings and deliver the care they say they do — couching that as a compromise between the “really long” process of getting approval for a medicine and the data-driven needs of startups where founders need to be able to show traction to get investment to build and grow a business in the first place.

“Healthcare’s already tough because you have to do clinical trials and it’s already a bit slower. So a longer approval process makes it even more difficult to launch something useful and I can see the UK, France, the Nordics bringing out some similar legislation to facilitate that,” he adds.

“We expect in other European countries — and in other countries in generally, like Canada, Australia and in Asia too — that they update their regulation to cover digital therapies. And then that will be good because we will know how to get apps prescribed and we know the other way, like in the U.S., [i.e. without needing to go through a doctor first]… And so with our app being so scalable we could easily launch in these countries compared to other companies in the market that are more reliant on one specific healthcare system or on hardware or anything that limits the scalability.”

Every day in the United States, hundreds of thousands of people will dial 911 to seek help. Some of those calls are serious and require immediate emergency attention, but the reality is that most 911 calls are of a far simpler variety: concerns about a prescription, fear over a newly-developed symptom, or a general medical question.

When a 911 call taker receives that request for medical assistance, it sets into motion a series of responses. Ambulances and paramedics are sent, leading to skyrocketing costs for patients and insurers alike. What if instead of sending hyper-expensive emergency services to a non-emergency situation, call takers had an ally to guide patients to the resources they actually need?

MD Ally is a startup that triages 911 calls and reroutes non-emergency calls to telehealth medical services. The company closed $3.5 million in seed funding led by Hemant Teneja at General Catalyst, along with Tuoyo Louis of Seae Ventures. The company formerly raised $1 million in financing last March.

Shanel Fields, the CEO and founder of the company, said that the impetus for the company came from a very early age. “It goes back to my own childhood — my father was a volunteer EMT when I was growing up on Long Island,” she said, and that interest in healthcare brought her to Athenahealth.

CEO and founder of MD Ally Shanel Fields. Image Credits: MD Ally

She kept thinking about 911 calls though, and the disparities that exist between different communities when it comes to response times. “Whether you have $5 dollars in your pocket or $5 million — you call the same number,” she said. But I “read some research that in low-income and indigent communities, they had higher rates of ‘dead on arrival’ due to higher wait times.” The reason was simple: in communities with less access to healthcare, emergency services are often the only alternative, leading to higher volumes of 911 calls with many that would be considered low priority.

That gave her the idea for MD Ally — to improve the efficiency of dispatching so that emergencies got first care, and that non-emergency calls could also be helpfully routed to improve clinical outcomes. She officially started building the company in Fall of 2019, and joined up with Kojo DeGraft-Hanson, who is the company’s chief product officer. The two have known each other for a decade from Cornell, and they stayed in touch as each pursued their own careers.

The company integrates into the computer-aided dispatch systems used by 911 operations centers (known more formally as Public Safety Answering Points or PSAPs). Today, when a 911 call comes in, call takers determine the acuity of the medical danger involved using an Advanced Medical Priority Dispatch System, a uniform process for coding each call by severity. MD Ally has established a range of codes that call takers can safely redirect to telehealth treatment options.

Best of all for cash-strapped 911 centers, MD Ally’s platform is free. The company instead intends to generate revenues on the provider side for telehealth referrals as well as from insurance companies looking to reduce the cost of emergency medical services. The company is integrating with centers in New York and Florida now and by the end of the year, hopes to also have centers on board in Louisiana, California, and Arizona.

Long-term, the company hopes to help deescalate situations where 911 callers, who might be experiencing mental illness, are sent police response rather than psychological services. We’re “really passionate about and excited to provide a range of resources to deescalate scenarios,” Fields said.

Swedish digital health startup Kry, which offers a telehealth service (and software tools) to connect clinicians with patients for remote consultations, last raised just before the pandemic hit in Western Europe, netting a €140M Series C in January 2020.

Today it’s announcing an oversubscribed sequel: The Series D raise clocks in at $312M (€262M) and will be used to keep stepping on the growth gas in the region.

Investors in this latest round for the 2015-founded startup are a mix of old and new backers: The Series D is led by CPP Investments (aka, the Canadian Pension Plan Investment Board) and Fidelity Management & Research LLC, with participation from existing investors including The Ontario Teachers’ Pension Plan, as well as European-based VC firms Index Ventures, Accel, Creandum and Project A.

The need for people to socially distance during the coronavirus pandemic has given obvious uplift to the telehealth category, accelerating the rate of adoption of digital health tools that enable remote consultations by both patients and clinicians. Kry quickly stepped in to offer a free service for doctors to conduct web-based consultations last year, saying at the time that it felt a huge responsibility to help.

That agility in a time of public health crisis has clearly paid off. Kry’s year-over-year growth in 2020 was 100% — meaning that the ~1.6M digital doctors appointments it had served up a year ago now exceed 3M. Some 6,000 clinicians are also now using its telehealth platform and software tools. (It doesn’t break out registered patient numbers).

Yet co-founder and CEO, Johannes Schildt, says that, in some ways, it’s been a rather quiet 12 months for healthcare demand.

Sure the pandemic has driven specific demand, related to COVID-19 — including around testing for the disease (a service Kry offers in some of its markets) — but he says national lockdowns and coronavirus concerns have also dampened some of the usual demand for healthcare. So he’s confident that the 100% growth rate Kry has seen amid the COVID-19 public health crisis is just a taster of what’s to come — as healthcare provision shifts toward more digital delivery.

“Obviously we have been on the right side of a global pandemic. And if you look back the mega trend was obviously there long before the pandemic but the pandemic has accelerated the trend and it has served us and the industry well in terms of anchoring what we do. It’s now very well anchored across the globe — that telemedicine and digital healthcare is a crucial part of the healthcare systems moving forward,” Schildt tells TechCrunch.

“Demand has been increasing during the year, most obviously, but if you look at the broader picture of healthcare delivery — in most European markets — you actually have healthcare usage at an all time low. Because a lot of people are not as sick anymore given that you have tight restrictions. So it’s this rather strange dynamic. If you look at healthcare usage in general it’s actually at an all time low. But telemedicine is on an upward trend and we are operating on higher volumes… than we did before. And that is great, and we have been hiring a lot of great clinicians and been shipping a lot of great tools for clinicians to make the shift to digital.”

The free version of Kry’s tools for clinicians generated “big uplift” for the business, per Schildt, but he’s more excited about the wider service delivery shifts that are happening as the pandemic has accelerated uptake of digital health tools.

“For me the biggest thing has been that [telemedicine is] now very well established, it’s well anchored… There is still a different level of maturity between different European markets. Even [at the time of Kry’s Series C round last year] telemedicine was maybe not something that was a given — for us it’s always been of course; for me it’s always been crystal clear that this is the way of the future; it’s a necessity, you need to shift a lot of the healthcare delivery to digital. We just need to get there.”

The shift to digital is a necessary one, Schildt argues, in order to widen access to (inevitably) limited healthcare resources vs ever growing demand (current pandemic lockdown dampeners excepted). This is why Kry’s focus has always been on solving inefficiencies in healthcare delivery.

It seeks to do that in a variety of ways — including by offering support tools for clinicians working in public healthcare systems (for example, more than 60% of all the GPs in the UK market, where most healthcare is delivered via the taxpayer-funded NHS, is using Kry’s tools, per Schildt); as well as (in a few markets) running a full healthcare service itself where it combines telemedicine with a network of physical clinics where users can go when they need to be examined in person by a clinician. It also has partnerships with private healthcare providers in Europe.

In short, Kry is agnostic about how it helps deliver healthcare. That philosophy extends to the tech side — meaning video consultations are just one component of its telemedicine business which offers remote consultations for a range of medical issues, including infections, skin conditions, stomach problems and psychological disorders. (Obviously not every issue can be treated remotely but at the primary care level there are plenty of doctor-patient visits that don’t need to take place in person.)

Kry’s product roadmap — which is getting an investment boost with this new funding — involves expanding its patient-facing app to offer more digitally delivered treatments, such as Internet Cognitive Based Therapy (ICBT) and mental health self-assessment tools. It also plans to invest in digital healthcare tools to support chronic healthcare conditions — whether by developing more digital treatments itself (either by digitizing existing, proven treatments or coming up with novel approaches), and/or expanding its capabilities via acquisitions and strategic partnerships, according to Schildt.

Over the past five+ years, a growing number of startups have been digitizing proven treatment programs, such as for disorders like insomnia and anxiety, or musculoskeletal and chronic conditions that might otherwise require accessing a physiotherapist in person. Options for partners for Kry to work with on expanding its platform are certainly plentiful — although it’s developed the ICBT programs in house so isn’t afraid to tackle the digital treatment side itself.

“Given that we are in the fourth round of this massive change and transition in healthcare it makes a lot of sense for us to continue to invest in great tools for clinicians to deliver high quality care at great efficiency and deepening the experience from the patient side so we can continue to help even more people,” says Schildt.

“A lot of what we do we do is through video and text but that’s just one part of it. Now we’re investing a lot in our mental health plans and doing ICBT treatment plans. We’re going deeper into chronic treatments. We have great tools for clinicians to deliver high quality care at scale. Both digitally and physically because our platform supports both of it. And we have put a lot of effort during this year to link together our digital healthcare delivery with our physical healthcare delivery that we sometimes run ourselves and we sometimes do in partnerships. So the video itself is just one piece of the puzzle. And for us it’s always been about making sure we saw this from the end consumer’s perspective, from the patient’s perspective.”

“I’m a patient myself and still a lot of what we do is driven by my own frustration on how inefficient the system is structured in some areas,” he adds. “You do have a lot of great clinicians out there but there’s truly a lack of patient focus and in a lot of European markets there’s a clear access problem. And that has always been our starting point — how can we make sure that we solve this in a better way for the patients? And then obviously that involves us both building strong tools and front ends for patients so they can easily access care and manage their health, be pro-active about their health. It also involves us building great tools for clinicians that they can operate and work within — and there we’re putting way more effort as well.

“A lot of clinicians are using our tools to deliver digital care — not only clinicians that we run ourselves but ones we’re partnering with. So we do a lot of it in partnerships. And then also, given that we are a European provider, it involves us partnering with both public and private payers to make sure that the end consumer can actually access care.”

Another batch of startups in the digital healthcare delivery space talk a big game about ‘democratizing’ access to healthcare with the help of AI-fuelled triage or even diagnosis chatbots — with the idea that these tools can replace at least some of the work done by human doctors. The loudest on that front is probably Babylon Health.

Kry, by contrast, has avoided flashy AI hype, even though its tools do frequently incorporate machine learning technology, per Schildt. It also doesn’t offer a diagnosis chatbot. The reason for its different emphasis comes back to the choice of problem to focus on: Inefficiencies in healthcare delivery — with Schildt arguing that decision-making by doctors isn’t anywhere near the top of the list of service pain-points in the sector.

“We’re obviously using what would be considered AI or machine learning tools in all products that we’re building. I think sometimes personally I’m a bit annoyed at companies screaming and shouting about the technology itself and less about what problem you are solving with it,” he tells us. “On the decision-support [front], we don’t have the same sort of chatbot system that some other companies do, no. It’s obviously something that we could build really effortlessly. But I think — for me — it’s always about asking yourself what is the problem that you’re solving for? For the patient. And to be honest I don’t find it very useful.

“In many cases, especially in primary care, you have two categories. You have patients that already know why they need help, because you have a urinary tract infection; you had it before. You have an eye infection. You have a rash —  you know that it’s a rash, you need to see someone, you need to get help. Or you’re worried about your symptoms and you’re not really sure what it is — and you need comfort. And I think we’re not there yet where a chatbot would give you that sort of comfort, if this is something severe or not. You still want to talk to a human being. So I think it’s of limited use.

“Then on the decision side of it — sort of making sure that clinicians are making better decisions — we are obviously doing decision support for our clinicians. But if it’s one thing clinicians are really good at it’s actually making decisions. And if you look into the inefficiencies in healthcare the decision-making process is not the inefficiency. The matching side is an inefficiency side.”

He gives the example of how much the Swedish healthcare system spends on translators (circa €200M) as a “huge inefficiency” that could be reduced simply — by smarter matching of multilingual clinicians to patients.

“Most of our doctors are bilingual but they’re not there at the same time as the patient. So on the matching side you have a lot of inefficiency — and that’s where we have spent time on, for example. How can we sort that, how can we make sure that a patient that is seeking help with us ends up with the right level of care? If that is someone that speaks your native language so you can actually understand each other. Is this something that could be fully treated by a nurse? Or should it be directly to a psychologist?”

“With all technology it’s always about how do we use technology to solve a real problem, it’s less about the technology itself,” he adds.

Another ‘inefficiency’ that can affect healthcare provision in Europe relates to a problematic incentive to try to shrink costs (and, if it’s private healthcare, maximize an insurer’s profits) by making it harder for patients to access primary medical care — whether through complicated claims processes or by offering a bare minimum of information and support to access services (or indeed limiting appointment availability), making patients do the legwork of tracking down a relevant professional for their particular complaint and obtaining a coveted slot to see them.

It’s a maddening dynamic in a sector that should be focused on making as many people as healthy as they possibly can be in order that they avoid as much disease as possible — obviously as that outcome is better for the patients themselves. But also given the costs involved in treating really sick people (medical and societal). A wide range of chronic conditions, from type 2 diabetes to lower back pain, can be particularly costly to treat and yet may be entirely preventable with the right interventions.

Schildt sees a key role for digital healthcare tools to drive a much needed shift toward the kind of preventative healthcare that would be better all round, for both patients and for healthcare costs.

“That annoys me a lot,” he says. “That’s sometimes how healthcare systems are structured because it’s just costly for them to deliver healthcare so they try to make it as hard as possible for people to access healthcare — which is an absurdity and also one of the reasons why you now have increasing costs in healthcare systems in general, it’s exactly that. Because you have a lack of access in the first point of contact, with primary care. And what happens is you do have a spillover effect to secondary care.

“We see that in the data in all European markets. You have people ending up in emergency rooms that should have been treated in primary care but they can’t access primary care because there’s no access — you don’t know how to get in there, it’s long waiting times, it’s just triaged to different levels without getting any help and you have people with urinary tract infections ending up in emergency rooms. It’s super costly… when you have healthcare systems trying to fend people off. That’s not the right way doing it. You have to — and I think we will be able to play a crucial role in that in the coming ten years — push the whole system into being more preventative and proactive and access is a key part of that.

“We want to make it very, very simple for the patients — that they should be able to reach out to us and we will direct you to the right level of care.”

With so much still to do tackling the challenges of healthcare delivery in Europe, Kry isn’t in a hurry to expand its services geographically. Its main markets are Sweden, Norway, France, Germany and the UK, where it operates a healthcare service itself (not necessarily nationwide), though it notes that it offers a video consultation service to 30 regional markets.

“Right now we are very European focused,” says Schildt, when asked whether it has any plans for a U.S. launch. “I would never say that we would never go outside of Europe but for here and now we are extremely focused on Europe, we know those markets very, very well. We know how to manoeuvre in the European systems.

“It’s a very different payer infrastructure in Europe vs the US and then it’s also so that focus is always king and Europe is the mega market. Healthcare is 10% of the GDP in all European markets, we don’t have to go outside of Europe to build a very big business. But for the time being I think it makes a lot of sense for us to stay focused.”

Disasters are, unfortunately, a growth business, and the frontlines that were once distant have moved much closer to home. Wildfires, hurricanes, floods, tornadoes — let alone a pandemic — has forced much of the United States and increasingly large swaths of the world to confront a new reality: few places are existentially secure.

How we respond to crises can radically adjust the ledger of mortality for the people slammed by these catastrophes. Good information, fast response, and strong execution can mean the difference between life and death. Yet, frontline workers often can’t get the tools and training they need, particularly new innovations that may not wind their way easily through the government supply chain. Perhaps most importantly, they often need post-traumatic care far after a disaster his dissipated.

Risk & Return is a unique venture fund and philanthropic hybrid that has set its mission to seek and finance the next-generation of technologies to help first responders not only on the frontlines, but even after as they confront the strains both physical and mental from missions they undertake.

The family of organizations sees a spectrum from emergency workers in the United States to U.S. military veterans, all of whom share similar challenges and need solutions today — solutions that can often be hard to finance for traditional VCs who aren’t aware of the unique needs of this community.

The group was founded by Robert Nelsen, who made his name as a co-founder and managing director of biotech VC leader ARCH Venture Partners, which last year announced a $1.5 billion pair of funds. He’s joined by board chairman Bob Kerrey, the former co-chair of the 9/11 Commission as well as former governor and senator of Nebraska, and managing director Jeff Eggers, a Navy SEAL who served as senior director of Afghanistan and Pakistan on President Barack Obama’s National Security Council.

Nelsen had been thinking through the idea when he met Kerrey, who recalled the conversation happening during a fundraising event for Navy SEALs. “There has been a lot of suffering for those who have been on the frontlines,” Kerrey said. “Bob had this idea, and I thought it was a really smart idea, to try to take a different approach to philanthropic efforts.” They linked up with Eggers and the trio brought Risk & Return to fruition.

The venture fund is $25 million, with about 35% of it already deployed. The fund has had a big emphasis on mental health for first responders, with 75% of the companies funded broadly in that category.

The fund’s first investment was into Alto Neuroscience, which is developing precision medicine tools to treat post-traumatic stress. The fund has also invested in behavioral management startup NeuroFlow; alternative well-being assessment tool Qntfy; Spear Human Performance, which is a brand-new spinout focused on connecting commercial and health data sources to optimize human performance; and Xtremity, which is designing better connection sockets for prosthetics. The fund has invested in another six startups including Perimeter, which I profiled a few weeks ago.

This isn’t your typical venture portfolio, and that’s exactly what Risk & Return wants to focus on. Eggers said that “We love that type of technology since it has that dual purpose: going to serve the first responder on the ground, but the community is also going to benefit.”

While many of the startups the firm has invested in obviously have a focus on first responders, the technologies they develop don’t have to be limited to just that market. Kerrey noted that “Every veteran is a civilian, [and] these aren’t businesses targeting the military market.” Given the last year, “it’s hard to find a human being in this pandemic that hasn’t suffered at least some PTSD,” referencing post-traumatic stress disorder. Sales to governments can be incredibly challenging, and the ultimate market for the kinds of specialized mental health services that frontline workers need may not be as commercially viable as one would hope.

While the government does research and innovation in this category, Kerrey sees a huge opportunity for the private sector to get more involved. “One thing that you could do in the private sector that is difficult in the public sector is look for alternative therapies for PTSD,” he said, noting that areas like psychedelics have intrigued the private sector even while the government would mostly not touch the category today. Risk & Return has not made an investment in that space at this time though.

Half of the returns from the fund will stream into Risk & Return’s philanthropic arm, which writes grants to charities along the same thesis of aiding frontline workers both on the job and after it. The organizations hope that by approaching the complicated response space with a multi-pronged approach, they can match potential needs with different sources of capital that are most appropriate.

We’ve increasingly seen this hybrid for-profit/non-profit venture model in other areas. Norrsken is a Swedish foundation and venture fund that is investing in areas like mental health, climate change, and other categories from the UN Sustainable Development Goals. MIT Solve is another program that is working on hybrid approaches to startup innovation, such as in pandemics and health security. While disasters are always looming, it’s great to see more innovation in financing this critical category of technology.

such as in pandemics and health security

Electronic health records (EHR) have long held promise as a means of unlocking new superpowers for caregiving and patients in the medical industry, but while they’ve been a thing for a long time, actually accessing and using them hasn’t been as quick to become a reality. That’s where Medchart comes in, providing access to health information between businesses, complete with informed patient consent, for using said data at scale. The startup just raised a $17 million Series A round, led by Crosslink Capital and Golden Ventures, and including funding from Stanford Law School, rapper Nas and others.

Medchart originally started out as more of a DTC play for healthcare data, providing access and portability to digital health information directly to patients. It sprung from the personal experience of co-founders James Bateman and Derrick Chow, who both faced personal challenges accessing and transferring health record information for relatives and loved ones during crucial healthcare crisis moments. Bateman, Medchart’s CEO, explained that their experience early on revealed that what was actually needed for the model to scale and work effectively was more of a B2B approach, with informed patient consent as the crucial component.

“We’re really focused on that patient consent and authorization component of letting you allow your data to be used and shared for various purposes,” Bateman said in an interview. “And then building that platform that lets you take that data and then put it to use for those businesses and services, that we’re classifying as ‘beyond care.’ Whether those are our core areas, which would be with your, your lawyer, or with an insurance provider, or clinical researcher — or beyond that, looking at a future vision of this really being a platform to power innovation, and all sorts of different apps and services that you could imagine that are typically outside that realm of direct care and treatment.”

Bateman explained that one of the main challenges in making patient health data actually work for these businesses that surround, but aren’t necessarily a core part of a care paradigm, is delivering data in a way that it’s actually useful to the receiving party. Traditionally, this has required a lot of painstaking manual work, like paralegals poring over paper documents to find information that isn’t necessarily consistently formatted or located.

“One of the things that we’ve been really focused on is understanding those business processes,” Bateman said. “That way, when we work with these businesses that are using this data — all permissioned by the patient — that we’re delivering what we call ‘the information,’ and not just the data. So what are the business decision points that you’re trying to make with this data?”

To accomplish this, Medchart makes use of AI and machine learning to create a deeper understanding of the data set in order to be able to intelligently answer the specific questions that data requesters have of the information. Therein lies their longterm value, since once that understanding is established, they can query the data much more easily to answer different questions depending on different business needs, without needing to re-parse the data every single time.

“Where we’re building these systems of intelligence on top of aggregate data, they are fully transferable to making decisions around policies for, for example, life insurance underwriting, or with pharmaceutical companies on real world evidence for their phase three, phase four clinical trials, and helping those teams to understand, you know, the the overall indicators and the preexisting conditions and what the outcomes are of the drugs under development or whatever they’re measuring in their study,” Bateman said.”

According to Ameet Shah, Partner at co-lead investor for the Series A Golden Ventures, this is the key ingredient in what Medchart is offering that makes the company’s offering so attractive in terms of long-term potential.

“What you want is you both depth and breadth, and you need predictability — you need to know that you’re actually getting like the full data set back,” Shah said in an interview. “There’s all these point solutions, depending on the type of clinic you’re looking at, and the type of record you’re accessing, and that’s not helpful to the requester. Right now, you’re putting the burden on them, and when we looked at it, we were just like ‘Oh, this is just a whole bunch of undifferentiated heavy lifting that the entire health tech ecosystem is trying to like solve for. So if [Medchart] can just commoditize that and drive the cost down as low as possible, you can unlock all these other new use cases that never could have been done before.”

One recent development that positions Medchart to facilitate even more novel use cases of patient data is the 21st Century Cures Act, which just went into effect on April 5, provides patients with immediate access, without charge, to all the health information in their electronic medical records. That sets up a huge potential opportunity in terms of portability, with informed consent, of patient data, and Bateman suggests it will greatly speed up innovation built upon the type of information access Medchart enables.

“I think there’s just going to be an absolute explosion in this space over the next two to three years,” Bateman said. “And at Medchart, we’ve already built all the infrastructure with connections to these large information systems. We’re already plugged in and providing the data and the value to the end users and the customers, and I think now you’re going to see this acceleration and adoption and growth in this area that we’re super well-positioned to be able to deliver on.”

There are any number of seed rounds that cross our desks every day, a never-ending march of enterprise software, consumer apps, games, hardware, biotech, and sometimes even a space startup. But amid the regular flow of funding news, it’s still rare to come across a company raising money to take on addiction with software. So when Affect’s $1 million seed round from AlleyCorp came to my attention, I wanted to learn a bit more.

As someone who went to rehab for alcohol use disorder in what appeared to be a partially renovated middle school where the highest-tech thing that was in our group rooms were chairs, the idea of using software to help addicts reduce use and get their life back intrigued me.

Focused on stimulant abuse in particular, the startup wants to help people addicted to methamphetamine, for example, fully cease their use of the drug. Affect CEO Kristin Muhlner talked me through the company’s efforts during an interview. In short, the Affect app combines contingency management (rewards for positive behaviors) and cognitive behavioral therapy, or CBT (a form of therapy with known impact on addiction). Regarding the latter, Muhlner told TechCrunch during an interview that well-known recovery programs like AA or SMART Recovery also use forms of CBT in their approaches to helping addicts

In app form, those two concepts break down into things like cash rewards for multi-day abstinence or attending a group session. And on the therapy front, Affect offers group therapy, individual therapy, addiction counseling, and drug testing.

Like many companies today, Affect intends to learn from more data; it expects, per a deck that TechCrunch was able to review, machine learning to help the company hone its model and service over time. Let’s hope.

Critically, Affect is not opposed to medically assisted recovery, which matters. There is, in some recovery-focused theologies, a belief that any sort of medical assistance is akin to merely replacing one addiction, or substance, with another. This harmful view is contradicted by science. So, to see Affect cite adjuvant medication in its own pitch materials was heartening.

Stimulant abuse is rampant in America, and meth addiction is among the most deadly drugs in the country. Meth is no fucking joke. The only good amount of meth usage is precisely and exactly zero meth usage. So what Affect is building could actually change the world for stimulant addicts if it works.

I honestly hope Affect company winds up raising a bit more to more fully test out its thesis regarding addiction recovery. With insurance companies picking up the tab for Affect’s software, it has a chance to reach lots of folks in need. So many, in fact, that when I asked its CEO how it was handling go to market work, she said that her company had been warned that her user group was hard to reach. However, after putting up a digital ad, her company had to take it down seven minutes later. How’s that for product-market fit.

Let’s hope we see more startups working on this problem. Addiction is not going away and older methods are not the only way forward for addicts.

Companies like Ro and Hims have capitalized on the need for more seamless and discreet access to health and wellness products that are part of everyday life. For men.

Stix is looking to do the same for women, and has today announced the raise of a $3.5 million seed round. The financing was co-led by Resolute Ventures and SWAT equity partners, with participation from Entrepreneurs Roundtable Accelerator, Bullish, and a variety of strategic angels. This brings the total amount raised by the company to $5 million.

Stix launched in 2019 with a D2C pregnancy test that was easy to buy and use, and that eliminated some of their associated stigma. For example, some pregnancy tests show a smiley face when a woman tests positive, despite the fact that not all women taking a pregnancy test want to be pregnant.

The company then expanded to ovulation tests and prenatal supplements. Most recently, Stix has moved into UTI diagnostics tests, pain relief products, and preventative supplements. This last product category is particularly important. First of all, women are 30 times more likely to get a UTI than men, according to womenshealth.gov, and more than half of all women will have at least one UTI in their lifetime. It’s a huge market.

Secondly, and perhaps more importantly, there are few if any diagnostic products out on the market that women can buy over the counter. In other words, it’s taxing for a woman to diagnose a UTI (usually having to go see a doctor) despite the fact that UTIs are incredibly common.

The FDA-cleared UTI test makes it much easier for women to take action and get some answers from the comfort of their own home. Stix offers these products as a subscription and gives customers the option to choose how frequently they’d like them delivered.

Stix was cofounded by Cynthia Plotch and Jamie Norwood. The startup is looking to build a full suite of not only products, but educational resources and content to help guide women through these hyper common, but difficult, experiences.

Stix has eight people on the team, including the cofounders, three of whom are people of color. All are women.

The startup is not alone in the market. Modern Fertility, for example, is selling ovulation and pregnancy tests direct to consumer and has distribution through big box retailers like Wal-Mart.

French startup Alan has raised a $220 million funding round at a $1.67 billion valuation (€185 million and €1.4 billion respectively). Coatue is leading the round with Dragoneer, Exor, and existing investors Index Ventures, Ribbit Capital and Temasek also participating.

Alan has been building health insurance products from scratch. When I first covered the company back in 2016, the startup had just managed to get approval from regulators to become an official health insurance company.

Since then, it’s been a not-so-slow and steady growth story as the company now covers 160,000 people. Overall, Alan generates over €100 million in annualized revenue. While most of that revenue is spent back on claims, it’s an impressive revenue trajectory.

Like other insurance companies, Alan has some capital requirements to comply with health insurance regulation. Alan has to raise more if it wants to insure more people. But that’s just part of the story as the startup still had enough cash on its bank account for the next 12 to 18 months.

“The context is that we managed to end the year 2020 very strong, finally — and I say finally because it’s been stressful until the last minute,” co-founder and CEO Jean-Charles Samuelian-Werve told me.

Alan managed to meet its goals and international expansion finally started to take off. Many startups try to raise when they’re in a strong position. You shouldn’t wait until you have your back against the wall and that’s exactly what’s happening here.

“We thought it was the right time and we had multiple term sheets. Even though valuation is really good we first looked at a partner that has a really long-term vision,” Samuelian-Werve said.

With today’s funding round, the company can iterate on its core product — health insurance — and everything that makes Alan a super app — a single app that lets you access several services. In France, employees are covered by both the national healthcare system and private insurance companies. Alan sells its products to other companies so that their employees are automatically covered by Alan contracts. It’s a sort of B2B2C play.

9,400 companies have opted for Alan in France, Belgium and Spain — the company’s home market remains its main market. Clients include WeWork, Deliveroo, JustEat, Vitaliance and Big Mamma. By 2023, Alan wants to reach 1 million members.

In order to gain more customers, Alan is betting on three pillars — product innovation, customer satisfaction through additional services, and expansions to new verticals and markets.

When it comes to product innovation, Alan has designed a modular insurance builder. Small companies can subscribe to Alan in a few clicks. Big companies can tweak every single parameter to build the right insurance package for them.

After that, the company tries to make it easy to manage your health insurance. You’ll soon be able to automatically manage sick leaves, change the employee affiliation status, etc. As for employees, the company has always promoted a transparent offering. For instance, you should know how much you’re going to pay out of pocket when you see a doctor. You can see a map of doctors around you and how much they charge on average. This way, there’s no surprise.

Alan also tries to reimburse you as quickly as possible. If it’s a straightforward claim, the startup tries to analyze and categorize your claim as quickly as possible and then issue an instant SEPA transfer. 75% of claims are reimbursed and available on your bank account in less than an hour.

These core product features definitely contributes to customer satisfaction. But Alan is expanding beyond insurance products with several additional services that should increase retention. For instance, you can chat with a doctor, get medical advice for your baby’s health, get a free meditation app subscription, start a telehealth appointment via a partner, talk with someone about your mental health, etc.

Those services contribute to turning Alan into a super app for your health. Essentially, as soon as you’re insured by Alan, you become a member and can access all those services without additional charges.

Eventually, Alan plans to launch a personal care guidance service to help you contact the right healthcare professional based on your health issue. In Spain, Alan can already book appointments for you.

Finally, Alan plans to reach new customers through aggressive expansion goals. The company plans to hire 400 people within the next three years and expand to other industries with tailor-made insurance products, such as retail, wholesale and manufacturing.

While the company is still going to focus on France, Belgium and Spain in the near future, it is looking at opportunities across Europe. So let’s see where Alan is going to expand next.

Based in Ho Chi Minh City, Docosan helps patients avoid long waits by letting them search and book doctors through its app. The company announced today it has raised more than $1 million in seed funding, which is claims is one of the largest seed rounds ever for a Vietnamese healthtech startup. The investment was led by AppWorks, the Taiwan-based early-stage investor and accelerator program, with participation from David Ma and Huat Ventures.

Founded in 2020, the app has been used by about 50,000 patients for bookings and now has more than 300 individual healthcare providers, ranging from small family pediatric clinics to neurosurgeons at large private hospitals, co-founder and chief executive officer Beth Ann Lopez told TechCrunch. Providers are vetted before being added to the platform and have on average 18 years of clinical experience.

Lopez said advance doctor bookings aren’t the norm in Vietnam. Instead, people who use private healthcare providers have to “choose between over 30,000 private hospitals and clinics spread across the hospital with huge variations in price and quality. This is why people use word of mouth recommendations from their family and friends to choose a healthcare provider. Then they show up at a hospital or clinic and wait in line, sometimes for hours.”

Docosan’s users can filter providers with criteria like location and specialty, and see pricing information and verified customer reviews. It recently added online payment features and insurance integrations. The company, which took part in Harvard’s Launch Lab X plans to launch telehealth and pharmacy services as well.

For healthcare providers on the app, Docosan provides software to manage bookings and ease wait times, a key selling point during the COVID-19 pandemic because many people are reluctant to sit in crowded waiting rooms. Lopez said another benefit is reducing the number of marketing and adminstrative tasks doctors have to do, allowing them to spend more time with patients.

The startup plans to expand into other countries. “Docosan is a solution that works well anywhere with a large, fragmented private healthcare system,” said Lopez. “We would all benefit from a world in which it’s as easy to find a great doctor as it is a book a Grab taxi.”

In press statement, AppWorks partner Andy Tsai said, “We noticed Docosan’s potential early on because of its participation in the AppWorks Accelerator. Docosan’s founders demonstrated strong experience and dedication to the healthcare issues in the region. We are proud to be supporting Docosan’s vision of better healthcare access for all.”

French startup Biloba has raised a $1.7 million funding round (€1.4 million) a few months after launching its pediatrics app that lets you chat with a doctor whenever you have a question. In addition to raising some money, the startup also recently added in-app prescriptions.

Biloba’s concept is surprisingly simple. It’s a mobile app that lets you reach a general practitioner and a nurse whenever you have a medical question about your child. The service is available from 8 AM to 10 PM.

When you start a conversation, it looks like a messaging app. You can send and receive messages but also send photos and videos. There’s no real-time video conversation, no appointment. The company says that you usually get an answer in less than 10 minutes.

Last year, Biloba raised a €1.2 million pre-seed round. This year’s €1.4 million’s seed round is led by Aglaé Ventures and ID4. Existing investors Calm/Storm Ventures, Inventures, Acequia Capital and several business angels are also participating once again.

A text conversation will never replace a visit to the pediatrician. And there are many medical interactions and milestones after a baby is born. But you may have questions and you don’t want to wait for the next appointment.

And if it’s a relatively harmless issue that doesn’t need an in-person appointment, Biloba can now issue prescriptions. You receive the prescriptions in the app and it is accepted in all French pharmacies. The startup uses Ordoclic for that feature.

Biloba thinks people shouldn’t pay per consultation — even though people are particularly well covered by the French national healthcare system and private health insurance. Instead, the startup has opted for a subscription model.

Parents pay €12.99 per month, €24.99 for a three-month subscription or €79.99 per year. After that, you can start as many conversations as you want. Biloba subscriptions aren’t covered by the French national healthcare system.

Basically, if you can afford a subscription, Biloba can increase the frequency of interactions with doctors, which should lead to better medical advice.

Image Credits: Biloba