Birdie, a U.K.-based caretech software-as-a-service maker, has closed a $30 million Series B funding round led by investment firm Sofina, with Omers Ventures and Index Ventures also participating — the latter reupping its backing after leading Birdie’s Series A last year.

Max Parmentier, co-founder and CEO of Birdie, said the latest tranche of funding will go on scaling into continental Europe where it’s started to sign partnerships with local care providers, as well as wider business growth. The new funding brings its total raised since being founded back in 2017 to $52 million.

In Birdie’s home market of the U.K., where it’s been operating for around five years, it’s now working with some 700 care businesses whose staff are delivering “millions” of visits per month to the circa 35,000 care recipients (and 8,000 family members) being supported by its customers — with growth of 3x since the startup last raised.

The SaaS platform provides care workers a suite of digital tools to support their work by streamlining admin and patient management while enabling real-time visibility into care events — helping keep family members informed of important details around their loved one’s care.

Birdie’s wider goal for the business is to use the data its platform is ingesting and structuring to power more personalized — and even preventative — healthcare for the social care sector, which remains drastically under-resourced versus the scale of demand for care services.

The sector also suffers from a chronic shortage of staff, which is likely driving investor interest in funding platforms like Birdie that promise to drive efficiencies for care customers.

“We want to become a technology partner for home healthcare across continental Europe, where we know the care industry is under increasing pressure,” Parmentier tells TechCrunch. “We’ve already signed new partners in Spain and are in advanced conversations with partners in Ireland. In the near future, we are looking at expanding our footprint to France, Germany and the Nordics.”

“Our first priority is to grow our solution so it can support any care provider, delivering any type of care at home — from complex care to live-in care as we want any older adult to be properly supported,” he adds.

“We are also constantly learning and adapting to better serve our partners and will be looking closely at our existing platform to expand its breadth and capabilities. For example we will be launching a new version of our rostering tool to optimise fulfilment rate, meaning less commuter time and more face-to-face interactions for carers and their care recipients.”

Another focus for the funding will be continuing to build out partnerships, per Parmentier. “We will continue to develop our open ecosystem to partner with health and care providers. Our aim is to invest heavily in building a clinical engine and enhancing our data analytics capabilities to offer predictive insights.”

Asked how Birdie quantifies efficiency gains for its target care provider customers, he points to a recent study which found that 73% of users save on average between 7-15 hours a week on day-to-day operations — as well as claiming the the platform offers 9x more visibility over day-to-day tasks than other care management software.

“It’s critical as fewer hours doing admin work mean more hours to care for the care recipients,” he argues.

To quantify the quality of care being delivered by users of its platform, the startup has created what it brands as the ‘Birdie Quality Score’ metric — which factors in criteria like alert responsiveness, call monitoring and medication monitoring — and then feeds the data back to care agencies to support them in monitoring and improving the care service they’re providing.

Parmentier says this data feedback loop is resulting in improvements in its care partners’ service quality.

“The aim here is to help them continually improve the quality of their care. As a result, within the first six months as a Birdie user, on average we see a 21% improvement in our partners’ quality score, with the biggest improvements within a year; 81% of all concerns are resolved in under 72 hours, and 80% of medication concerns are resolved within a 72 hour period — up from 58% within the first month. This is a huge improvement and a testament to the ongoing work of the team.”

Discussing progress on Birdie’s longer term goal of using the care data-points that are being fed into its platform to power a personalized and predictive value-based healthcare delivery model, Parmentier says it’s created its own ontology for tasks and assessments — “based on a well-known comprehensive geriatric assessment framework”.

“The best part is, we’re already seeing the benefits of this data-driven approach and can validate scientific knowledge through our own data. We’re using AI models such as NLP [natural language processing] to further enhance our data analytics capabilities and anticipate health and wellbeing trends for a care recipient,” he goes on.

“Looking ahead, we want to continue to improve our health outcomes, while also scaling the platform. We are already able to recommend specific well-being assessments based on care recipient data but we want to grow this focus and look at particular condition-specific interventions, such as mobility and mental health.”

“From the beginning, our thesis has been that a data-driven solution to home care can help us deliver personalised care to an aging population. We’ve built Birdie around this concept, and we’re now capable of collecting millions of data points every day that were previously captured on paper, making us the social care platform with the most structured data,” he adds.

On the competitive front, Parmentier says there are numerous legacy SaaS providers in the care sector — some focused on care assessment, others providing tools in people and operations management. But he argues Birdie’s modern, platform approach is helping it stand out in a crowd.

“Our all-in-one platform uniquely encompasses digital solutions across the entire care business, and we differentiate ourselves by delivering user-centric products accompanied by a high-touch service approach,” he suggests. “Additionally, by working closely with our partners to provide integrated analytics and insights that highlight performance gaps, we are not only streamlining and digitising many existing processes but we are ultimately improving the quality of care they are providing.”

Commenting on Birdie’s Series B in a statement, Harold Boël, CEO of Sofina, said: “The home healthcare tech sector seems ripe for an innovative leader like Birdie to catalyse the necessary social change. Aligned with our strategy to back growing and sustainable businesses, we’re excited to join them on their mission to enrich the lives of millions of older adults through preventive and personalised care at home.”

“What really sets Birdie apart is the combination of an intuitive product experience coupled with a true partnership approach to digital transformation,” added Stéphane Kurgan, venture partner at Index in another supporting statement. “We continue to be impressed by the team’s passion, calibre and commitment to social change and are proud to accompany them on their quest to reinvent care for the better.”

Caring for a family member is not only hard work, but expensive, too. Many family caregivers miss work (or stop working) and pay for medical expenses out of pocket. Aidaly was created to help them find sources for compensation and financial aid.

The company, which is coming out of stealth mode, announced that it has raised $8.5 million in funding led by Alexis Ohanian’s Seven Seven Six, with participation from Lightspeed Venture Partners, Operator Partners, Precursor Ventures, Primetime Partners, Scribble, Shrug, Polymath and TVC. Founders and executives from companies like Twitter, Facebook, SoulCycle, Flatiron Health, Mainstreet, OnDeck and Commsor also participated.

The funding will be used to expand into new markets across the United States. Aidaly is currently active in the Miami-Dade area.

Aidaly points toward statistics showing that there are 53 million unpaid family caregivers in the United States, with almost eight in 10 reporting routine out-of-pocket expenses averaging $7,242 per year. The fact that many employers only offer minimal medical and family leave compounds the problem, since caregivers often have to chose between having a full-time job or looking after their family member.

Medicare and Medicaid dollars cover some services, but they can be difficult to apply for. Aidaly’s role is making access to state and private benefits easier, along with services like financial planning, mental health support and caregivers training. The platform also helps users manage paperwork, and the company says it can help identify if someone is eligible for benefits in less than 15 minutes. This is especially important because it means caregivers might discover financial sources they were previously unaware of.

Aidaly founder and CEO Maggie Norris has her own experience with the challenges facing caregivers and their families. “I am extremely fortunate to have two dads and was able to care for them both in their battles with cancer,” she told TechCrunch. “The experience of that parent-child role reversal gave me much more empathy and gratitude for life and for family.”

“It also opened my eyes to the lack of resources available to family caregivers and the miscalculation of their role in the greater healthcare system, which is a great loss to society,” she added. “Aidaly was founded with the mission to enable families to provide long-term care to the people they love through providing compensation and financial services. Early users have already seen a 160% increase in their ability to recover from financial shocks, such as a sudden change in health or employment.”

Aidaly supports people who provide on average 15 to 25 hours of care per week. About 80% of them are family members and the rest are non-relatives. In order to take advantage of Aidaly’s offerings, caregivers first supply identification like a driver’s license. Aidaly verifies their identity, validates their insurance and runs a background check in under five minutes.

Then Aidaly scans a database of hundreds of programs and benefits to maximize caregivers’ payouts. Just a few examples include Medicaid Managed Care Programs, Medicaid Waivers and Programs, Participant-Direction/Self-Direction programs and Non-Medicaid Home Care and HCBS programs.

Norris said that the biggest payers are federal and state health plans. “Competitive Medicare Advantage plans turn to Aidaly to offer innovative family caregiver compensation programs. Now more than ever, members want the freedom to live and receive care in their homes, surrounded by people they choose.”

She added, “The reality is that if you follow the money it all flows from the same sources,” Norris added. “There are thousands of disparate programs, benefits and credits with unique systems and processes to achieve the same outcome. Aidaly’s goal is to replace them all. One radically simple solution for enabling patient-directed and family-provided care.”

In a statement to TechCrunch, Ohanian said, “There’s a massive need: countless caregivers doing invaluable work that’s not getting recognized without Aidaly. Anytime a founder is solving such a massive and valuable problem—that’s a business I’m leaning into.”

Apple’s health business could now stand alone as one of the largest in the sector in terms of sheer reach — if it could ever be disentangled from the company’s other products, which, by design, it really can’t. At the company’s annual WWDC global developer conference last week, a variety of new health-related features were introduced that cover not only the wellness-oriented Apple Watch lineup, but also the company’s iPhone, iPad and beyond.

From product design, to participation in academic research, and to hiring, Apple has demonstrated a concerted effort to do more in health, and I spoke to Chief Operating Officer Jeff Williams, Vice President of Health Dr. Sumbul Desai and Vice President of Fitness Technologies Jay Blahnik following its WWDC announcements to learn more about just how important health and wellness are to the consumer technology giant’s ambitions.

Williams started off by reiterating something I’ve heard from Apple in the past on the subject: As a company, it never really set out with a strong intent to get into the health business in the beginning — at least not in the way it set out to develop a product like the iPod or the iPhone.

“It started when we were working on the watch,” he said. “And because the watch was such a personal device, and you’re wearing it, we thought that there is a huge opportunity to maybe give people information about their health, and the more we started pulling on threads, we decided that not only is there an opportunity — there’s a responsibility to do more in the health space.”

Williams said that the impact of that felt responsibility is what has resulted in the many health features Apple has introduced in the years since the Watch’s introduction, both on the Watch and across its platforms. Ultimately, Williams said, Apple has two “fundamental tenets” that undergird its approach to introducing new health-related products and services: that they be “deeply grounded in science,” and that “privacy is at the core of everything” Apple does.

Informed patients, augmented physicians

Those principles are at the heart of the new features Apple unveiled at the conference, according to Desai, who pointed to the scientific rigor behind their introduction of sleep stage tracking for the Apple Watch, and the fresh FDA clearance of their AFib history feature, which will roll out to Apple Watch users in the U.S. with the watchOS 9 update sometime this fall.

Image Credits: Apple

“As Jeff alluded to, everything we do in health is based on the science, and AFib history was validated in a clinical study, with participants wearing both Apple Watch and an FDA-cleared reference device,” Desai told me. “In that study, the average difference in weekly measurements between the two devices is actually less than 1%.”

That’s a remarkably thin margin for a piece of non-specialized consumer tech, which comes with the added benefit of being worn by owners consistently for the bulk of the day over a period that can span years — a claim no dedicated medical heart-rate monitor can match.

The significance of offering AFib history as something Apple Watch owners can share with their physicians, combined with all the other health data that they can export via PDF should they choose to share a more complete picture, might not be immediately apparent, but it represents a depth and breadth of individual patient data that healthcare professionals have never had access to before. I asked about how this kind of groundbreaking work will impact healthcare as a whole, and whether Apple is working with medical professionals on understanding those impacts.

Desai (a physician herself) pointed out that Apple spends “a lot of time talking to physicians,” both on studies like the one it’s conducting with Toronto’s University Health Network (UHN) which we covered last year, and in other capacities as well.

“We don’t want to throw technology over the wall,” Desai explained. “We want to actually bring the physicians along so that they understand where how this can be used, because to your point, it’s going to change their practice, and it’s also going to change their interactions with their patients.”

“It’s clear to us that the future of healthcare still has the patient-physician relationship at the center of it,” Williams said. “We just want to enhance that. We don’t view that technology somehow replaces [that], we just view that it enhances that relationship and in the future, you’ll have a much more empowered patient, and a physician who is able to operate at the top of their license because they just have a better set of information with which to work.”

Williams acknowledged that features as detailed as AFib history “will take some time” to be “understood, used and adopted,” but he cited one powerful way it could have an immediate impact: Detecting a case in which a patient receives an ablation treatment to resolve chronic AFib, but in which that treatment doesn’t take the first time and the AFib (which would be otherwise asymptomatic) remains.

Apple is also introducing medication reminder features to Health, including the ability to scan labels to add your own medicines, and get reminders to hopefully improve adherence to their intended use. It’ll also provide users with info about potential negative interactions, and offer yet another way in which patients can have more informed conversations with their doctors with actual data to back them up.

Super sleep science

Apple’s approach to sleep tracking is likewise backed by science, and promises to contribute still more back to the research community through a new Apple sleep study that the company is adding to its ongoing heart study as an opt-in option for Apple Watch owners to join when the new update launches. Williams prefaced the feature by acknowledging that Apple is hardly the first to do sleep stage tracking (dedicated health-tracking companies including Oura and Whoop have been offering that for years, for instance), but again references a need to feel confident in the science behind the feature before bringing it to the public.

“The machine learning models that were trained, were validated against the clinical gold standard of polysomnography [a type of multi-parameter sleep study],” Desai added. “And this was actually one of the largest and most diverse populations ever studied for a wearable.”

Image Credits: Apple

“Prior to sleep stages, we were really focused on helping people meet their sleep duration goals, since that’s really important — that consistency — but we wanted to go a little further and dig into the science, and provide users with more information around their sleep cycles,” Desai explained. “So using the signals from Apple Watch’s accelerometer and heart rate sensor, users will now be able to see their sleep stages while they’re in REM, core and deep sleep.”

Apple’s use of ‘core’ to define the type of sleep users spend the bulk of their nights engaged in, which is more commonly referred to by other sleep stage trackers as ‘light,’ is an interesting break from the field: The company found that ‘light’ wasn’t really the best descriptor, since it tended to strike the average user as something meriting concern, when in fact it’s a perfectly normal part of the overall sleep cycle.

It’s a good example of how Apple continually strives to balance a desire to add increasing power and sophistication to its health features, while maintaining their approachability and accessibility to a very broad audience. That’s also a key ingredient in their approach to the changes coming in their new Fitness features unveiled at WWDC.

Keeping fitness fun while serving fanatics

Blahnik has been with Apple since before the Apple Watch was introduced, and he’s overseen the company build its fitness features from fairly fundamental activity tracking, to a sophisticated suite of metric management and a variety of professional, guided workouts. At WWDC, Apple made a number of big announcements around Fitness, including bringing simple activity tracking directly to the iPhone for users who don’t have a Watch, as well as a bunch of new metrics, features and sport types for enthusiast and advanced athletes, and improvements to the Fitness+ subscription workout service.

“Over the years, we’ve continued to push further and further, because we know different things motivate different people,” Blahnik said. “And we want to make sure that we’re constantly providing variety for different personalities, and for the things that motivate people.”

The updates include three new metrics for runners that can help avoid injuries, including stride length, ground contact time and vertical oscillation. Blahnik pointed out that these are typically captured using a range of specialized equipment or direct observation by a professional, and that they’re “really difficult to do from the wrist.” Still, he says Apple was able to build algorithms that track them reliably, and then display them either directly during a workout session, or afterwards in the workout summary.

Considering Apple spent a lot of time talking about these, and other advanced features like custom workouts and automatic tri-sport workout detection for triathletes, I asked Blahnik how Apple determines when and where to address more advanced needs, vs. more general population features.

“Prior to Apple Watch, most most people wouldn’t know, unless they brought their phone, even how far they had run, and […] the more that this kind of information becomes available, you do find users want more,” he said. “Or they maybe get on a journey where they’re going to do their first 5k, and they start reading more about their health. And so while [the new metrics] do seem advanced, I’m always amazed at the fact that some of what we measured in the beginning seemed advanced as well.”

Image Credits: Apple

Blahnik says that in the early Apple Watch days, even having access to the basic three rings that Apple still uses to categorize and present its health data in summary — Stand, Move and Exercise — was itself “advanced” compared to what was generally available. Still, even if users are seeking more granular feedback, he notes that the challenge is in introducing sophistication while still welcoming in those who might find the full scope of what Apple Health has become overwhelming.

“I think for us, it’s just a journey where we’re constantly wanting to offer more, trying to build the features in a way that are usable and inspiring to both beginners and advanced athletes, and then never burdening the person that just wants to come in and start the experiment,” he said, pointing out that the Workout app still looks and feels the same when first opened, and reveals its complexity as you choose to dive in.

Health is quotidian

Apple’s health efforts have evolved from a subset of one among many of a single ancillary device’s features, into something that spans the company’s entire product ecosystem, and that both informs and welcomes collaboration from healthcare practitioners and researchers globally. I asked Williams for a sense of how that shift has led Apple to think differently about its overall approach to product development.

“I think everyone has an appreciation for the fact that these devices are with you all the time,” he said. “We have this huge opportunity to help people with their health and so, broadly — with everything from Screen Time, which is ultimately a health thing, since there’s a huge mental health crisis, and we think something like Screen Time helps contribute to people’s wellbeing — all the way across the company, people think about ways in which our products and services can help people from a health standpoint.”

At the end of last year, just before Christmas, Oracle made a big move when it announced it was acquiring electronic health records company Cerner for $28 billion, thrusting it quickly into the top enterprise deal for 2021, just under the wire.

Today, the company announced it has closed the deal, effective tomorrow.

The announcement was anticlimactic in a way, full of corporate financial speak: “Oracle Corporation (NYSE: ORCL) announced that a majority of the outstanding shares (the “Shares”) of Cerner Corporation (Nasdaq: CERN) were validly tendered, and the other conditions to the tender offer have been satisfied or waived. The deal will close on June 8, 2022,” the company wrote in statement.

In other words, it got past the oversight of the world’s regulatory bodies and paid off the amount due. With the contracts signed and the stock transferred (or it will be by midnight tonight), the deal is effectively done.

You may recall that Microsoft paid almost $20 billion for Nuance Communications in April 2021 — that deal closed in March. Seeing the same market potential as Microsoft, Oracle paid a pretty penny for Cerner to dive headlong into the healthcare market.

At the time the deal was announced, Holger Mueller, an analyst at Constellation Research, said it would bring the lucrative market to the Oracle cloud, and that’s why the company was willing to pay so much for it.

“It’s a smart move by Oracle. It cements Oracle technology even deeper into healthcare, and brings a lot of current and especially future work load to Oracle Cloud. Not to mention that Oracle is buying into the largest and fastest-growing vertical industry,” Mueller told me at the time.

Cerner certainly has the potential to do that, but it depends on how the two companies fit together in the end, and if Oracle can take all of that market potential and turn it into a viable business inside Oracle. However it turns out, the deal is done as of midnight tonight.

Apple is doubling down on making the Apple Watch the best health-tracking wearable out there and expanding features for its most demanding users — as well as everyone else. The next version of its watchOS will include a number of new health-related features, including the tracking of new metrics, automatic multisport tracking, improved sleep tracking and more.

iOS 16 will also bring the Fitness app to all iPhone users, not just those with an Apple Watch, as has previously been the case. It’ll track walking info and other metrics to approximate your fitness level.

Sleep tracking now includes sleep-stage tracking, which will tell you how long you spend in each stages, including REM, core and deep sleep stages, and when you woke up. Apple is using machine learning models that take cues from heart-rate tracking, as well as blood oxygen readings and respiratory rate to determine which stage you’re in, and they say they validated the data against the “clinical gold standard of polysomnography.”

On watchOS, you’ll now be able to track three new running metrics to track efficiency, including vertical oscillation, stride length, ground contact time and heart-rate zones. These are all metrics that high-performance athletes use to really refine their performance. You can also take advantage of new views with the digital crow including a heart-rate zone view, and you can create custom workouts to track improvements in specific metrics.

There’s a new triathlete-focused ability that auto-switches between running, biking and swimming to track the course of an entire workout too.

Apple is adding medication tracking to watchOS and iOS, too, letting you search and enter common medications and get alerted when you’re supposed to take it.

After setting out to examine digital healthcare from the inside by launching its own women’s health clinic as an app last year, French startup Nabla is executing the next step in a planned pivot to b2b — announcing today that it’s opened its machine learning tech stack to other digital health businesses and healthcare providers so they can offer what it bills as “personalized medicine”.

Nabla’s AI-powered patient communications and engagement/retention platform is designed to support clinicians to deliver a more continuous, data-driven service, whether the client is offering real-time telehealth consultations or delivering a service to patients via asynchronous, text-based messaging.

Nabla’s messaging and teleconsultation communication modules sit as a layer atop the customer healthcare service, ingesting and structuring patient data — with its machine learning software supporting clinicians with real-time prompts and visualizations, as well as offering ongoing patient outreach features to extend service provision.

The startup argues its approach can improve medical outcomes by supporting healthcare professionals to be able to ask relevant questions during a consultation, based on the AI’s ability to aggregate patient activity and surface contextually relevant data — and afterwards, with features like automated transcription and by suggesting updates a clinician could make to a patient’s medical file.

It likens the platform’s capabilities to having a really attentive family doctor who knows their patient’s full medical history and situation — and has a fault-less memory for all that detail. But the tech can go beyond what even a great doctor can offer as it enables healthcare providers to supplement in person consultations with ongoing, asynchronous outreach to provide a layer of continuous care — such as via follow on scheduled messaging (e.g to offer treatment reminders or ask patients about their progress etc). And, of course, even the best human doctor isn’t going to be able to provide patients with that level of check-in and attention in between visits.

Nabla’s premise is therefore that blending digitally delivered, synchronous (human) care with data-driven (AI-powered) support and asynchronous follow ups can offer a win-win: For patients, who get more ongoing (and potentially holistic) care than they could expect from traditional healthcare service delivery; and for digital health businesses which get to drive customer engagement and retention thanks to the smart, personalized assistance and outreach enabled by its platform.

Customer retention has become a pressing problem for digital healthcare providers, Nabla argues — pointing out that after the flood of interest in the space during the pandemic many of these businesses are likely coming back down to Earth with a bump as patient attention disperses, and as the wider global downturn complicates the task of scaling by raising funding.

“Health tech of course is affected a lot by the economic downturn,” says co-founder and CEO Alexandre Lebrun. “Around us we see lots of health tech startups that… owing to the COVID-19 crisis they automatically had lots of patients… It was very easy for them to get lots of patients and engagement. And now that COVID-19 is over — and plus cash is not free anymore — they discovered they have the same problems as ecommerce companies — I have to take care of my customers, I have to work on retention, I have to make them happy. It’s not just automatic.”

Nabla is not (currently) in the business of automating healthcare; rather its platform offers real-time clinician support and clinician-approved outreach to patients — which means that, crucially, a qualified human doctor remains in the loop and in charge of patient care decision-making at all times. So its product is not itself a medical device — although Lebrun can envisage taking further steps in that direction down the line.

“Our long term goal is to use this data not just for the benefit of one patient but learn and aggregate all this data and, for instance, try to predict what will happen next with the patient or to do faster diagnostics,” he tells TechCrunch. “Of course the data we have is super valuable for research because we have very, very detailed information about the patient and not just the typical hospital records… [We have data on] what they eat, how they live, their social environment, family environment — we know it’s very important for health but this information is nowhere to be found in existing medical records. But we have part of it. And so this is incredibly valuable for future academic research — and when we ask our users would you agree to share this data for medical research… most say yes of course, if they understand the scope of what we share.”

Lebrun cut his teeth in tech working on chatbots — and clearly has a strong appreciation of the limitations of the technology. After selling a prior AI startup (Wit.ai) to Facebook he stayed on at the tech giant to work on developing its hybrid general purpose AI concierge service (aka “M“) — which Facebook ultimately decided did not scale for its user base. But Lebrun had seen the potential of combining human-plus-AI for decision-making support, and decided to return to startup land to apply a similar hybrid approach in the narrower domain of healthcare where utility looked easier to hone.

Setting up and running a women’s health clinic was how Nabla’s founders subsequently decided to get to know the needs of the industry they wanted to supply and support with machine learning software — launching their clinic as an app in April 2021. The app, which Nabla says it will continue operating for the moment (although it’s no longer their main focus or product), has amassed some 25,000 patients to date.

This approach means Nabla’s tech is in the relatively novel position — certainly compared to general health products historically — of having been informed during development, primarily, by women’s experience. And its co-founders argue that’s resulted in a product which is both more attentive vs alternatives and more useful as a healthcare tool regardless of the sex of the user. So another win-win, as they tell it.

Having direct access to patients and doctors through the clinic provided Nabla with a link to core users, data and expertise it needed to develop the machine learning health stack product it’s now seeking to monetize. Although it emphasizes that patient data confidentiality requirements has meant always working with strict limits on data access — such as its engineers not being able to directly access users’ medical information (including during development of the AI-powered tech stack).

“I think the consequence of choosing women’s health is that we focused a lot on empathetic care. On the continuous and pluri-disciplinary aspect of the care — and that is completely forgotten in the existing healthcare systems,” suggests Lebrun. “It was a hard decision to make for me to say okay I’m opening a women’s health clinic. I started to spend all my day learning lots with gynecologists… If my co-founder was not a woman I wouldn’t have had the confidence to start a women’s health clinic. So it was great. We didn’t plan it when we started Nabla together — but it was good,” he adds.

“It enabled us to focus a lot on these things. Empathy, pluri-disciplinarity on the provider side, and trying to have a whole person view of the patient is more important for women than for men. I’m a man, I have a problem with my arm, I go to the doctor, ten minutes later I know what to do. That’s solved — but this is not what women need. And this is not what the existing system provides. So we learnt quickly to provide this kind of care with a mix of asynchronous and synchronous care. And what’s interesting is we realized that now, today, that this kind of care is actually better for everyone. Even for men.”

“What we really want to build is a patient engagement stack,” adds Delphine Groll, who is co-founder and COO. “And when we did some research we did a lot of beta version of the app and we found that women were the more engaged population regarding remote care. And as our focus was to drive engagement thanks to our ML models it was — I think — the best choice to have this kind of population so we could be in a position where we could understand a lot the insights from them and then put the best stack we could regarding engagement, retention… which is the main challenge healthcare companies have at the moment. So I think it was not the only reason — but one of the reasons we choose also to focus on women’s health.”

Nabla’s communication modules, which are connected to its machine learning-powered physician console, have been available to third parties, via APIs and SDKs, for about the past three months — and it says it’s signed up around 10 customers so far — but it’s announcing the formal opening today.

Early customers — which span a range of markets including the US, the UK and France in Europe, and Africa — include digital health startups such as Resilience, Cardiologs, Aura Fertility, Omena, Umana, Jeen, and Tchak; and established healthcare organizations such as AP-HP, which it notes is the largest hospital group in Europe. The idea is for the b2b business to be international from the get-go, per Groll.

Discussing the competitive landscape, Lebrun names as its closest rivals the US firms Canvas Medical, Seqster and Zus Health — and he confirms Nabla has strong designs on the US market, given how much digital healthcare action it accounts for.

“The closest companies are all in the US where, I think, they understood quite quickly that there will be a new tech stack of healthcare — like what happened in ecommerce 20 years ago — where every piece of ecommerce is managed by one of a few companies and then you assemble these bricks. The same thing is starting to happen in healthcare,” he argues, also likening Nabla’s approach to clinician support as akin to GitHub’s ‘AI pair programmer’ software, Copilot.  

“There is no question we’ll compete soon. Of course the needs are slightly different in the US. These competitors — I think we have the same philosophy of enabling healthcare providers to build the experience they want and make the life of the healthcare providers, of the doctors easier. But I think we have more focus on asynchronous care — how building asynchronous with synchronous care is interesting.

“Machine learning can of course help do that and with our 20 years and three companies before in the machine learning [space] I think we have great real world experience… We know what’s possible, what’s not possible and what’s desirable or not and we are trying to apply this.”

Groll suggests Nabla’s edge vs rivals is its focus on not just extracting what patients are telling their doctors but structuring that information so that it can be put to work in wider service of improving healthcare provision for them by surfacing suggestions for personalized follow-ups — and also, potentially, for research purposes, if patients agree. (Patient consent for their data to be processed is required for use of the AI-powered service; and, separately, for any wider sharing of aggregated and anonymized data for research purposes, the startup confirms.)

“When we are talking to potential clients what they really like at the end of the day is we are extracting the data from all the communication — especially messaging and teleconsultation — and we are not only extracting it… we are also structuring it and normalizing it so it can make a strong asset for them,” she says, adding: “So I believe our differentiation is… we are enabling them to have a communication module but also to have a way to leverage the data they have inside those communications.”

On the research side, Lebrun suggests the approach — as/if Nabla scales usage — will likely entail collaborations between its healthcare provider partners and public research institutions that would carry out studies in specific areas of interest, relying on aggregated, anonymized data from the service provider/s.

“Research is better conducted by public institutions or academia,” he argues. “So I think it would be a three parties collaboration where Nabla’s providers agree to contribute their data. They of course they ask the consent from their patients to agree to share their data. And then the academic partner or public institution does the actual research but you could see Nabla as a network of healthcare providers who can have an easy way — because it’s already structured — to contribute data for research.”

Between one-to-one therapy and free online forums, people search for a range of solutions to mental health therapy online. Especially since the pandemic increased anxiety and depression rose by 25% globally (according to WHO) and also deepened an epidemic of loneliness.

Among players in the online group emotional support space there is Pace (which raised $14.9M), Grouport (raised $1.5M), and Quilt.

Circles, a platform for online group emotional support, joined the fray in 2020, and has today raised $16.5 million in a Series A round led by Zeev Ventures. Also participating was Lior Ron, Head of Uber Freight, along with existing investors NFX, Flint Capital, and Sir Ronald Cohen.

With Circles, subscribers talk about life challenges such as divorce, grief and infertility, meeting weekly via group video chat to give and receive emotional support. Circles says the process is guided by “trained and vetted” mental health professionals.

Circles claims it fills the market gap between ‘therapy and Facebook groups’ by combining professionals with the support of peers going through the same experiences, and is also available on an app, which likely aids user retention.

Irad Eichler, co-founder of Circles said in a statement: “With this new round of funding, we’ll strengthen our matching technology to match with more accuracy, increasing each group’s predisposition for success.”

Eichler previously founded “Shekulo Tov,” a nonprofit organization that assists the mentally handicapped integrate into society. He claims 70-75% of Circles’ members use the platform at least once a week and 30% use it daily.

“Circles is addressing a gap in the market with the powerful yet simple principle of human connection. Propelled by leadership with proven experience in successful social impact initiatives, Circles has positioned itself to be a market leader,” commented Oren Zeev, of Zeev Ventures. 

It’s been a tough few years for Berlin-based femtech hardware startup Inne which came out of stealth R&D in the fall of 2019, shortly before COVID-19 hit Europe. By January 2020, founder and CEO Eirini Rapti tells us she was busy making final inspections ahead of the launch of its debut product — a connected device it calls a “minilab” for at-home, saliva-based hormone testing to support fertility and cycle tracking — but then, in just a few weeks, the region was plunged into lockdown and everything changed.

Hardware startups are rarely smooth sailing at the best of times. But the coronavirus pandemic created a cascade of new challenges for Rapti and her team around supply chain and logistics — upsetting their careful calculations on unit economics. The pandemic also called a halt to a major piece of research work the startup had lined up with a US university to study its hormone-tracking method for a key contraceptive use-case — a product it had intended to prioritize but could not bring to market ahead of the study which is required to gain regulatory approval.

In a matter of weeks, Inne was forced to freeze its big launch as it tried to figure out how best to move forward — and, indeed, whether it should launch the product at all in such a challengingly reconfigured environment.

“Due to COVID-19 we’ve had to really shift around our plans,” says Rapti, talking to TechCrunch via video chat. “We had loads of unpredicted supply chain issues… There were so many fuck-ups that came up with COVID-19! It’s unbelievable what happened.

“I remember our last interview [in October 2019], I was super optimistic — I’m still very optimistic — sort of really looking forward to get all of our tech out to the world. We were setting up our production line when I spoke to you. We had John Hopkins [research university] agreeing to our contraceptive study. Like, the world was my oyster… And then I came back from a last inspection of the goods coming off the production line in January 2020 and we were hearing about what was happening in China but we were not really conscious of it and then we were so busy with pre-sales and whatever.

“And then of course a month later we didn’t know if we were going to get raw materials from China. We didn’t know if the factories that were working within Europe were going to even be able to have people in the factory. ”

The start of the planned contraception study also kept being postponed, as the US research institution which had agreed to conduct it, pre-pandemic, understandably prioritized work related to COVID-19 itself.

The upshot for Inne was a shock freeze on its best laid plans — plans Rapti had been working towards since 2017 when she founded the business and kicked off R&D to get the at-home hormone testing product to market.

“2020 for me started on this big high — we had our final products, we got our approval [to sell the device in Europe], we are launching pre-sales. I think we had 200 people buy the product and then we kind of had to stop because we didn’t know if we were even able to deliver these 200… This is how bad it was,” she adds.

As well as having shelled out to set up a production line it suddenly had to suspend, Inne had also doubled the size of its team to prepare for scaling. But suddenly the message from the investment world was ‘slow everything down’, recounts Rapti. “So I was like why didn’t you tell me two months ago?!… My whole strategy came crumbling down.”

The supply chain and logistics disruption — some of which has lingered even while pandemic lockdowns have eased — also forced Inne to concentrate most of its effort on the German market in Europe — “because we wanted to contain, as much as possible, the logistical nightmare”, as she puts it.

“Electronic chip shortages of course are affecting everyone… but it’s also as simple as backlog on logistics,” she explains, discussing how COVID-19 has dialled up difficulties for the fledgling hardware business. “Your shipments take longer or your air freight is much more expensive and all of a sudden your price per unit becomes really high — and for a small company like us, for a startup, if you cannot demonstrate your unit economics and your growth what can you demonstrate? And quite frankly I was sitting there for a few months — and I think it was the first time I froze in my career where I felt I have no idea what I will be able to show in the next six months!”

By summer 2020, Rapti was facing a big decision over how to move forward while the business was still mired in uncertainties around supply chain resilience and with no new date on when it would be able to launch contraception as it still hadn’t found a replacement partner to do the study.

Additionally, it was unclear when the startup would be able to raise more funding in such a challenging climate. Yet, given the expanded team Rapti had put in place ahead of the 2020 launch, she needed to consider burn rate — which meant deciding whether she had to let staff go to give the startup the best chance of surviving so much disruption.

The choice boiled down to two options, per Rapti: Either cut everything right back, keeping only a bare minimum of staff to extend the runway and find another, probably European-based institution to carry out the contraceptive study; or reduce cash burn a bit but go ahead and launch the minilab with only fertility and cycle tracking — meaning there could be no user messaging on natural contraception, limiting the product’s utility to (only) women trying to get pregnant or those looking for help with an irregular cycle.

In the event, Rapti went for the second choice — saying she was, above all, keen to keep the team she’d built up. She also saw an opportunity to use a partial launch to at least learn about the market, even though continuing supply chain constraints meant Inne had to limit the number of devices shipped to make sure they could provide the full service to the first buyers (its subscription-based progesterone testing service works with packs of single-use daily testing strips to gather the user’s saliva sample, with testing performed by inserting the moistened strip into the minilab for analysis).

“The first year we could circulate — I think — 500 devices, or very little, without having delays. And I think we closed last year with close to 2,000 customers,” Rapti adds.

Outside Germany, Inne also has some early users in Austria, Switzerland and the U.K. — but the launch has clearly been a very different and more painstaking process than Rapti had envisaged from her high in fall 2019.

Another cloud she may not have expected to see looming on the horizon now is the prospect of the US Supreme Court overturning constitutional protections for abortion in the US — which, followed a leaked opinion on Roe v Wade earlier this month, is already causing consternation over the risks that digital services like period tracking apps could pose to US women if their data can be used to track them or to try to build prosecutions around their reproductive health.

“I’m horrified by what is happening to the US,” says Rapti when asked whether she is concerned about this risk. “The reality is we are not right now in a position where, legislatively wise, someone could ask for this data to be used against women in court — as of today. So what I truly believe is it would be counterproductive to go backwards and, instead of giving women access to and understanding of their own data, to say actually we need to scrap all that because it could be used against them.

“I think this would be really a step backwards. But rather I think what our job is — as female health companies — is to defend the rights of our users and also make the data as anonymous as possible so it cannot be traced back to the actual user.”

Rapti argues there is a clear way to separate profile data that is used for marketing from health data generated by usage of the product — and says Inne’s approach for the latter is currently to use double encryption and split usage data and also where it’s processed (some of which she says happens on the user’s device) so that it’s not all sitting in a single repository which it could be easily ordered to hand over.

But she also says the startup would be prepared to create further protections for user data in response to any changes to the law that threaten women’s rights.

“We need to be legally on top of things and make sure that whenever there is a law that is passed we change our product fast in order to guarantee this anonymity as much as possible,” she tells TechCrunch. “And I would rather we invest in that legal capacity on our side than to say we stay away from having women tracking their data because the government could use it. But I definitely see it as our job. We need to be on top of legislative lobbying, if I can put it that way, and make fast changes to our product in the way that data is structured so that we can protect [our users] as much as possible.”

Series A expansion

Today, Inne has better news: An extension to that $8.8M Series A round it closed back in 2019. It’s taking an addition $10M now so it can stock up on raw materials and retool its production line to unplug any remaining production bottlenecks. The expansion to the Series A is led by DSM Ventures, with Borski Fund and Calm Storm Ventures also participating, along with a number of angels, including Taavet Hinrikus (Wise), Dr Fiona Pathiraja and Rolf Schromgens (Trivago).

But not only that — Rapti says it’s planning to expand its product offering to include another hormone test — for cortisol (aka, the stress hormone; tracking cortisol can be useful for athletic performance, as well as for links to wider women’s health issues).

It is also set to its first steps outside Europe later this summer, via a US partnership with a women’s health brand called Phenology. The tie-up will be exclusively focused on perimenopause — so Inne will be getting a toe in the water in that major market while it waits on regulatory clearance for its digital contractive.

The US partner will offer Inne’s device to a subset of its users as a way to track changes in their hormones during the early stage of the menopause — supplementing the services it offers them, which includes personalized wellness programs and  supplements. (Notably, Phenology’s parent, a company called Hologram Sciences, shares an investor with Inne — DSM Ventures, aka the venture arm of Dutch vitamin giant DSM — so you can see the investment synergies at work there.)

“It was clear there was a synergy and a very clear geographical separation also — US and then Europe — and they’re not interested in contraception which I always wanted us to own fully globally,” notes Rapti. “And that’s kind of how, through seeing that Hologram Sciences would actually be a great partner for expanding our use-cases to the US, we decided on DSM Ventures being an investor in this round.”

She confirms Inne has finally been able to get a contraceptive study underway this year with a new partner in Europe, saying she expects the work to be completed around November — paving the way for Inne to be able to launch a contraceptive product in Q1 next year. That will put it into competition with the likes of Natural Cycles‘ basal-temperature based ‘digital contraceptive’ (which got regulatory clearance in Europe back in 2017); and period tracking app Clue’s more recent cycle-tracking system which gained FDA clearance for contraception in March 2021, to name two existing products.

So, demand willing, the pieces needed to scale Inne’s hormone-tracking femtech business do finally look to be slotting into place.

“I think it was the right thing to do,” adds Rapti, returning to her decision to go ahead and launch in the middle of the pandemic — to “see who buys the product” and “connect with the customers” — even if that choice meant delaying the launch of the contraceptive product.

Image credits: Inne

“It took me a long time to find especially the science and data science team that losing them over a crisis like this would have been, in the longer term, the worse ordeal,” she adds. “Because you find scientists, you make them product people and product thinking and then to let them go… It’s our core competence so that’s the first thing that I thought.”

Certainly Inne will face more competition when it finally launches its rival contraception. But that’s not necessarily a bad thing in such a novel space where women must be convinced they can trust new entrants’ methods over more tried and tested products for avoiding pregnancy like the pill and condoms.

Going ahead and launching with just fertility and cycle tracking also, of course, allowed Inne to road-test its team as it switched into commercial operations, serving those early customers. So it had a chance to iron out operational and service wrinkles with a small customer base, ahead of what it hopes will be wider scaling — as it expands both its production capacity and the product’s feature set with the help of the extra Series A funding.

Hormone tracking for the quantified self

So who are Inne’s early adopters? “We attract women who are on the less regular side of the cycle, so either have had several miscarriages or have had hormonal issues or have had very fluctuating cycles. So our data is biased towards irregularity,” says Rapti, also noting that users tend to be computer savvy and active on social media, where it does much of its marketing.

Ages of users range from 18 to mid 50s — but with a “peak” between 28 to 38, per Rapti.

Tracking progesterone means Inne can tell users whether they have ovulated or not — which, in turn, could help them detect a month when they have not ovulated, which (for people seeking to get pregnant) could help them understand challenges they may be having. For others, hormone tracking may be helpful to navigate patterns in an irregular menstrual cycle.

Other femtech products can rely on different approaches to try to predict fertility — such as temperature measurements or algorithmic analysis of cycle tracking data — but, as Rapti puts it, “the beauty of progesterone is it can really tell you has it happened or not”, so it’s offering a binary confirmation.

She says the majority of Inne’s users at present are using it for fertility tracking to help them get pregnant, with a smaller proportion (30% last year; but so far this year it’s getting closer to 40%, per Rapti) using it for cycle tracking to manage irregular periods. But she emphasizes that usage is “fluid” and “a bit of a journey” as women’s needs also change.

“We have two modes in the app: You can choose it either to cycle track, basically, but with hormones or to get pregnant,” she explains, adding: “It is such a fluid journey for a women in our product because the data tells me that some women are starting to track their cycle and then they will change their goal in a couple of months so it looks like maybe they’re preparing or they just came off the pill etc.”

Rapti’s wider vision is for the product to be able to “offer something all the way from the first period to the last period” — which is why she’s so keen to get the contraception product launched (asked if she thinks it’ll be the bigger market she says she’s not sure — but, just in pure numbers terms, there are obviously more women of fertile age seeking to avoid pregnancy than wanting to get pregnant at any given moment); as well as to build out utility elsewhere, such as by expanding into cortisol tracking.

The forthcoming cortisol test will provide users with the ability to understand whether they are going through a prolonged period of stress that has chemically affected their body, per Rapti — which she says may in turn be impacting their fertility or sports performance.

Users will be able to specify whether they want to include cortisol tracking in their Inne subscription and, if so, they will be sent a mix of progesterone and cortisol testing strips. But while the former is typically a daily test (which should be taken within a ~three hour window in the morning), the cortisol test is different; it’s not intended to be taken daily but when it is performed it needs to be done multiple times per day (and then that process repeated at intervals).

“You build the profile daily, with cortisol,” explains Rapti. “You do five measurements in one day and you do them every month for example, or every two weeks. But it’s not about, you know, ‘I do a test today and I do a test tomorrow and I see how my stress is’. No, it’s really that you’re building a chemical profile of your day and then you look at that over a period of time to try and understand if you really are under sustained stress and it has chemically affected your body or not.”

The thinking behind adding a second hormone test is not to address a broader range of users but rather to give women more reasons to get the minilab into their lives, per Rapit, by encouraging them to “trust these hormonal insights”.

Inne founder and CEO, Eirini Rapti (Image credits: Inne)

A major update to the next release of Inne’s app will bring a raft of self-reporting options — around what it’s calling “symptoms and events” — which is intended to help users link their daily activity/feelings with hormonal changes they can track using the product.

“We are launching 41 symptoms and events that people have asked for but which will also help us give more specialist insights because we will correlate them with hormones in the coming months,” she says. “They fall in different categories — about exercise, nutrition, certain things such as headache or migraines which are related to hormones; skin conditions, hydration/dehydration. They go from exercise to lifestyle to food to skin. And different types of body pain.”

“The beauty of being able to do that with hormones is you really see [the chemical change] — the opportunity we have here is we know the chemical role of hormones, can we truly related them to self-reported symptoms? And to what extent can we do that,” she adds, confirming: “It’s a long term correlation project. We didn’t want to start with it because we wanted to make sure that hormonal data were always going to take the center stage so we needed a large data pool first to establish what we’re doing and then try to see if it can correlate.”

Here Inne’s products looks as if it could push into ‘quantified self’ territory — with potential utility overlap with a recent wave of biosensing startups and companies that are seeking to commercialize continuous glucose monitoring (CGM) hardware for a more general health/sports performance use-case (i.e. beyond the management of blood glucose for people with diabetes or prediabetes for which the CGM sensing tech was originally developed). And where there are similar question marks over the wider consumer utility of that sort of biosensing (i.e. whether the average consumer can usefully interpret all this real-time biological feedback).

But one built-in advantage Inne’s approach has vs CGM startups is it’s non-invasive. And a consumer may feel more inclined to try something experimental on the off-chance they could discover a helpful correlation if it only requires them to moisten a some test strips in their mouth a few times a month, rather than — in the case of CGM-based glucose tracking — having to live with a biowearable and its metal filament under the skin of their arm for weeks at a time.

Rapti says Inne’s plan is not to break out a totally separate service around cortisol tracking — although she stresses the test itself does involve a completely different user experience — rather the goal is to serve users who want to gain a deeper understanding of how hormones affect their bodies.

“Instead of selling new strips to a different woman what I’m trying to say is this is going to be your subscription and then you tell us what you’re interested in. And if you’re interested in both stress and cycle tracking or fertility then we will send you every month strips of both and we will instruct you what to do when. So we’re not looking to make upselling with new strips but more deeper hormonal understanding so the price will remain the same. And you’ll just get a combination of strips for that same monthly price,” she says.

“I had so many people in this raise who said oh that would be amazing for men, why don’t you sell it to men! Do you know what, I think it would be amazing for men but how about we wait a minute and just offer it to women!” she adds.

There is clearly lots more Inne could do and add. So an obvious challenge is how to create a clear marketing message around such a multifaceted product?

On that Rapti says they’ve got one big takeaway: Women want to get specific about the benefits — which means finding fora where they can discover the product but also get to ask their own questions.

“It is a very early market. I feel that women know that there’s so much they can learn about their bodies and quite frankly we are giving a new angle where we’re like — hey, look, we should be able to track our hormones because [women] have been excluded from research for all those years and if only we had been included we would have known so much more about medication, our bodies, everything around that. So let’s bridge that gap — that’s our mission. And at the same time they’re like this is great but what exactly can you do for me?” says Rapit.

“So the way we’ve been approaching it — what I can tell you works — is to be very precise on what benefit they can get. And that’s why Instagram and influencer marketing works because women get the chance to ask questions and to really understand if this will serve them or not.”

Google is facing a new class-action style lawsuit in the UK in relation to a health data scandal that broke back in 2016, when it emerged that its AI division, DeepMind, had been passed data on more than a million patients as part of an app development project by the Royal Free NHS Trust in London — without the patients’ knowledge or consent.

The Trust was later sanctioned by the UK’s data protection watchdog which found, in mid 2017, that it had breached uk data protection law when it signed the 2015 data-sharing deal with DeepMind. However the tech firm — which had been engaged by the Trust to help develop an app wrapper for an NHS algorithm to alert clinicians to the early signs of acute kidney injury (aka the Streams app) — avoided sanction since the Trust had been directly responsible for sending it the patients’ data.

So it’s interesting that this private litigation is targeting Google and DeepMind Technologies, several years later. (Albeit, if a claim seeking damages against one of the world’s most valuable companies prevails there is likely to be considerably more upside vs litigation aimed at a publicly funded healthcare Trust.)

Mishcon de Reya, the law firm that’s been engaged to represent the sole named claimant, a man called Andrew Prismall — who says he’s bringing the suit on behalf of approximately 1.6 million individuals whose records were passed to DeepMind — said the litigation will seek damages for unlawful use of patients’ confidential medical records. The claim is being brought in the High Court of Justice of England & Wales.

The law firm also confirmed that the Royal Free is not being sued.

“The claim is for Misuse of Private Information by Google and DeepMind. This is under common law,” a spokeswoman for Mishcon de Reya told us. “We can also confirm this is a damages claim.”

A similar claim, announced last September, was discontinued, according to the spokeswoman — who confirmed: “This is a new claim for the misuse of private information.”

In a statement on why he’s suing Google/DeepMind, Prismall said: “I hope that this case can achieve a fair outcome and closure for the many patients whose confidential records were — without the patients’ knowledge — obtained and used by these large tech companies.”

“This claim is particularly important as it should provide some much-needed clarity as to the proper parameters in which technology companies can be allowed to access and make use of private health information,” added Ben Lasserson, partner at Mishcon de Reya, in another supporting statement.

The firm notes that the litigation is being funded by a litigation finance agreement with Litigation Capital Management Ltd, a Sydney, Australia headquartered entity which it describes as an alternative asset manager specialising in dispute financing solutions internationally.

Google was contacted for comment on the new suit but at the time of writing the adtech giant had not responded.

There has been an uptake in class-action style litigations targeting tech giants over misuse of data in Europe, although a number have focused on trying to bring claims under data protection law.

One such case, a long-running consumer class action-style suit in the UK against Google related to a historic overriding of Safari users’ privacy settings, failed in the UK Supreme Court last year.  However Prismall is (now) suing for damages under the common law tort of misuse of private information so the failure of that earlier UK case does not necessarily have strong relevance here.

It does appear to explain why the earlier suit was discontinued and a fresh one filed, though. “It’s correct that the previous claim was brought on the basis of a breach to the Data Protection Act and the new claim is being brought on a for misuse of private information,” Mishcon de Reya’s spokeswoman told us when we asked about this. 

While the DeepMind NHS patient data scandal may seem like (very) old news, there was plenty of criticism of the regulatory response at the time — as the Trust itself did not face anything more than reputational damage.

It was not, for example, ordered to tell DeepMind to delete patient data — and DeepMind was able to carry on inking deals with other NHS Trusts to roll out the app despite it having been developed without a valid legal basis to use the patient data in the first place.

And while DeepMind had defended itself against privacy concerns attached to its adtech parent Google, claiming the latter would have no access to the sensitive medical data after the scandal broke, it subsequently handed off its health division to Google, in 2018, meaning the adtech giant directly took over the role of supplying and supporting the app for NHS Trusts and processing patients’ data… (Which may be why both Google and DeepMind Technologies are named in the suit.)

There was also the issue of the memorandum of understanding inked between DeepMind and the Royal Free which set out a five-year plan to build AI models using NHS patient data. Though DeepMind always claimed no patient data had been processed for AI.

In a further twist to the saga last summer, Google announced it would be shuttering the Streams app — which, at the time, was still being used by the Royal Free NHS Trust. The Trust claimed it would continue using the app despite Google announcing its intention to decommission it — raising questions over the security of patient data once support (e.g. security patching) got withdrawn by Google.

While the tech giant may have been hoping to put the whole saga behind it by quietly shuttering Streams it will now either have to defend itself in court, generating fresh publicity for the 2015 NHS data misuse scandal — or offer to settle in order to make the suit go away quietly. (And the litigation funders are, presumably, sniffing enough opportunity either way.)

The backlash against market-dominating tech giants continues to fuel other types of class-action style lawsuits. Earlier this year, for example, a major suit was launched against Facebook’s parent, Meta, seeking billions in damages for alleged abuse of UK competition law. But the jury is out on which — or whether — representative actions targeting tech giants’ data processing habits will prevail.

At its Google I/O developer conference, Google and Samsung today announced Health Connect, a new initiative that will simplify the connectivity between health and fitness apps to allow users to share their data across apps.

Currently, accessing and syncing this data this relatively difficult for developers, so Health Connect will give them a series of services and APIs to make this easier.

“Health Connect lets you store and access health-related information across devices with user consent, taking out all the boilerplate code, taking care of the security issues, but also allowing you to mash up that information,” Sean McBreen, who leads developer experience for Android at Google, told me in a briefing ahead of today’s announcement. He stressed that like with all things Wear OS, Google worked closely with Samsung on this project, so going forward, apps like Google Fit, Samsung Health, MyFitnessPal, Leap Fitness, Withings and others will also start using this new API, which will give these services a new sync surface on the device.

Image Credits: Google

Essentially, Health Connect will function as the on-device clearinghouse for health and fitness data. Indeed, all of the data is on the device and encrypted to ensure privacy. “Users will have full control over their privacy settings, with granular controls to see which apps are requesting access to data at any given time,” Google explains. This also means users can easily shut off access or delete data as they see fit.

One neat feature: if multiple apps provide the same data, users can choose which one to prioritize.

The beta of Health Connect is now available to developers on Google Play so they can start building on top of it and testing their apps.

French startup Alan has raised a new €183 million funding round ($193 million at today’s exchange rate). The company sells its own health insurance products and has expanded to other medical products and services. In other words, Alan wants to build a healthcare super app and a one-stop shop for all your questions and needs when it comes to your health.

“We decided to raise again at the start of the year,” co-founder and CEO Jean-Charles Samuelian-Werve told me. “We’ve been receiving some investment requests. We could see that markets could turn around and we didn’t know how long it was going to last. Now, we are self-sustaining and will be until we reach profitability.”

Teachers’ Venture Growth (TVG), the venture fund of the Ontario Teachers’ Pension Plan Board, is leading the round. Existing investors are also participating in this new round, such as Temasek, Index Ventures, Coatue, Ribbit Capital, Exor, Dragoneer and Lakestar.

Today’s round is a Series E round and it comes just a year after the startup raised its €185 million Series D. While Alan has essentially raised the same amount of money twice, the company’s post-money valuation has jumped quite drastically. Last year, the startup was valued at €1.4 billion. It has now reached a €2.7 billion valuation (that’s respectively $1.5 billion and $2.9 billion at today’s exchange rate).

Alan’s core business and biggest revenue source hasn’t changed. The company is a health insurance company built for the 21st century. After getting approval from regulators, Alan has built its own underwriting engine.

The company can now sign up clients of all sizes and from all industries. Big companies can tweak every single parameter to build the right insurance package for them.

As for people who are covered by Alan’s health insurance, the experience is better than with other insurance companies. Alan tries to automate as many processes as possible so that the user experience is as seamless as possible.

For instance, if you’re paying at the doctor’s office and it’s a simple bill, Alan automatically processes the bill and transfers money to your bank account via an instant transfer. The result is that you are often reimbursed before you are back home. France’s national healthcare system will also reimburse its part automatically, but that usually takes a few days.

“We keep rolling out our model, which is 100% based on the loss ratio formula. We sell insurance products at cost — more or less. And then we add our membership fee on top. This model works really well,” Samuelian-Werve said.

And the company has managed to attract 300,000 members so far across 15,000 companies. Alan now says it generates an annualized revenue of €200 million.

Image Credits: Alan

Not just an insurance company

Alan’s founders have been clear about their vision from the very beginning. They don’t just want to build an insurance company. They want to build a healthcare startup that expands beyond insurance products.

Very quickly, users discovered that they can use the Alan app to find a health professional near them using Alan Map. The company is also working with general practitioners so that they can answer your questions from a chat interface.

Not all of those side bets have worked. A year and a half ago, Alan launched Alan Baby, a second app focused on your baby’s health. It provided a mix of content, some community discussions and the ability to start a discussion with a doctor. The company is going to shut down Alan Baby in the coming weeks.

“In 2022 and 2023, mental health is going to be a very high priority. That’s why we decided to shut down Alan Baby so that we could reallocate resources,” Samuelian-Werve told me.

When it comes to mental well-being, Alan offers a consumer app following the acquisition of Jour. There’s also a B2B service called Alan Mind.

The company provides exercises and content. Employees can also contact an expert whenever they need to. Some companies subscribe to Alan Mind exclusively. Others add the Alan Mind package to their existing Alan contract.

With Alan Clear, Alan now also offers a way to try on glasses using augmented reality. If you find a pair that you like, you can buy it directly through the app.

By the end of 2025, Alan wants to reach profitability. It will require 3 million members, but the startup also plans to hire 1,000 people by then. The company currently operates in France, Belgium and Spain. There won’t be any new market in 2022, but Alan could launch a new country in 2023.

While Alan has ambitious goals, it currently has a tiny market share. “96% of the French population has health insurance coverage. We still have less than 1% in market share,” Samuelian-Werve said.

“We are at the very beginning of our story. It is a first baby step but everything is still ahead of us,” he added.

Image Credits: Alan

Digital therapeutics plus pills? Iceland’s Sidekick Health has developed a gamified digital care platform that’s designed to support healthcare outcomes by applying personalized behavioral lifestyle nudges, including alongside clinical treatments like drugs, to augment, extend and support patient care for a range of chronic diseases and conditions from cancer to cardiovascular health, diabetes and arthritis — a formula that’s now scored it $55M in Series B growth funding.

The new round is led by London-based VC firm Novator Ventures, with participation from Wellington Partners, Asabys Partners, and Frumtak Ventures, as well as a US-based strategic investor which it’s not disclosing yet but says will be revealed at a later stage. The 2014-founded startup raised a $20M Series A back in 2020 from many of the same investors.

As the Series B closes, Novator Ventures’ general partner and founder Birgir Mar Ragnarsson is joining Sidekick’s board.

Commenting in a statement, he said: “It has been impressive to follow the rapid growth of the company from the close of its A round 18 months ago. The company may have begun in the Nordics but I am proud to say that Sidekick is now a globally-recognized digital therapeutics player. Novator Ventures recognizes the immense opportunities presented by third generation therapeutics and Sidekick’s ability to scale and operate at the global level. We look forward to working closely with the Sidekick team to transform how healthcare is delivered.”

Sidekick Health still isn’t breaking out overall customer numbers (it’s a b2b digital health business so its targeting health insurance firms and pharma companies) but says it’s inked partnerships with some of the biggest names in healthcare — such as US-based Anthem to offer “digital-first” care programs, and global pharma giants Bayer and Pfizer, to develop what it describes as “integrated combination therapeutics consisting of a molecular drug and a digital therapeutic”.

The startup tells us its platform has helped 40,000+ patients globally at this stage, with its products currently available in six languages. It largest markets are Europe and the U.S., while it has offices in the U.S., Germany, Sweden and its home market of Iceland. Flush with growth funding it says it has a big U.S. push planned.

“Europe and the U.S. are currently our largest markets but we are forging some partnerships in Asia,” it tells TechCrunch. “But it is early days, and we will be focusing hard on increasing our commercial footprint in the U.S. going forward.

“Sidekick will use the funding to support and expand our existing U.S. presence. Our North American strength and focus is exemplified by the recent additions of Pamela Stahl (CCO and President, North America) and Mitchell Mudra (COO) to the team. By 2026, it is estimated a billion people will be served by some form of DTx [digital therapeutics] annually. Coupled with the U.S. spending a very high proportion of GDP on healthcare, the U.S. is a market where our products and services will achieve the strongest patient outcomes.”

The startup tells TechCrunch it grew revenue threefold in 2021 — attributing that growth to a mix of existing and new commercial relationships. “This year Sidekick plans to double our team from 120 to 240 team members across our four office locations,” it adds.

Pharma giants look keen on digital therapeutics not only as a scalable tool to (potentially) augment the efficacy of their drugs with app-based support (e.g. by putting digital tools in patients’ hands that can help remind them to take pills and support them in other ways, such as to make beneficial lifestyle changes around diet and exercise, or get on-demand help with mental health issues or pain management etc), but as a way to extend the value of medicines — enabling drug giants to file new patents linking existing medicines to digital therapeutic programs that are far cheaper and easier to develop and iterate than he costly business of drug discovery and research.

“We are building towards a portfolio of over 40 medical-grade digital therapeutics by 2026,” says Sidekick, discussing its product roadmap. “Currently, 18 are in Research & Development, with a total of 14 commercial partnerships secured so far, either with payers or pharma partners or, in some cases, both.”

“Sidekick has commercialized digital therapeutic products already, in therapeutic areas ranging from rheumatoid arthritis, ulcerative colitis to nonalcoholic steatohepatitis and breast cancer,” it adds. “We will prioritize a substantial amount of our resources towards expanding our oncology portfolio, as well as investing into increased personalization, which will allow us to serve people with multiple chronic conditions even better.”

With Series B funding in the bank, Sidekick also has more partnerships in the works — with three new collaborations set to be announced in the coming months including one focused on supporting patients with breast cancer by helping patients manage side effects.

The startup has published a number of studies aimed at proving out the efficacy of its digital therapeutics –including looking at use of its platform to reduce stress and fatigue in patients with inflammatory bowel disease; or this small feasibility study into improving disease management for patients with ulcerative colitis; and this small randomized control trial examining use of its digital lifestyle program for outpatient treatment of Type 2 diabetes, to name a few — and it says it takes “life science-grade evidence generation very seriously to ensure that we offer clinical companies a clinical-grade product for their patients”.

“Top 10 and 20 pharma and Top 3 Payers are partnering with us on their ‘future of franchise’ assets, in areas like oncology, metabolic, cardiovascular, and immunology and immunotoxicology,” it adds, suggesting that its “life science quality evidence rigor and approach to precision medicine is driving this”.