Berlin-based Mayd has spied an opportunity to build out a medicine delivery platform in Europe which partners with the small-scale pharmacies that tend to be the norm on the continent, capitializing on how the pandemic has generally accelerated demand for on-demand delivery.

The startup, which was only founded at the beginning of this year, has bagged €13 million ($15M) in seed funding from 468 Capital, Earlybird and Target Global to build out its vision of delivering meds to Europeans’ doors fast — within 30 minutes if they’re ordered before noon (or the next day, at a selected slot starting from 8am).

Regulatory restrictions and fragmentation across Europe, with a patchwork of per-country rules around prescriptions, may explain why this use-case hasn’t already been sewn up by a handful of pharmacy or platform giants.

The picture for medicine delivery in Europe is very different vs the US, per Mayd co-founder Lukas Pieczonka, who notes that a patchwork of rules can apply in different countries in Europe — including (still) some limitations on e-prescriptions.

“Most of the US companies they are pharmacies. So they have a pharmacy licence for every state or for a selected number of states and they are operating as a pharmacy. For us it’s not true — we are a platform for pharmacies and for consumers,” he says. “We won’t be a pharmacy. We will heavily work in a very tight way with our partners but we are not a pharmacy. I think this is the biggest difference.”

In Germany, where Mayd is starting out, the country is in the process of gearing up for an e-prescription system that’s due to go live in January — as part of wider moves to digitize healthcare services (such as by bringing in electronic patient records).

Such per country regulations likely (partly) explains the meaty size of Mayd’s seed raise, along with the usual tech and recruitment challenges of scaling an urban logistics app business.

“In Germany there is a different situation who can deliver medicine. At the end the pharmacist needs control of the delivery process which is slightly different from the typical delivery model,” notes Pieczonka. “We set up an infrastructure where [the pharmacist] can really control what kind of rider is now delivering what to whom… If the pharmacist, for example, puts the wrong medicine in the bag or something you should always be able to stop the delivery.

“Secondly there’s a lot of regulatory stuff you need to also implement in your marketplace… so it’s not like you can just add it if you’re a food delivery or whatever delivery. You really need to focus on the specific segment in order to also have the credibility for the pharmacies.”

From next year, Germans will be able to get a digital prescription from their doctor which they can send to a pharmacy to fulfil — with reimbursement of the associated health insurance claim tied in.

Doing e-prescription delivery also means integrating with specific pharmacy infrastructure — which in Germany will involve the use of QR codes.

So again it’s not just another product that can be slung in the backpack of a gigging food delivery rider.

That said, European regulations haven’t been a complete blocker to launching such a model earlier, per Pieczonka. But he argues the timing is right now — with growing digitization of healthcare services and people in the region far more open to app-based delivery and convenience than they may have been pre-pandemic.

“In general we could have done this model two years ago. Actually this was also the first thing we were wondering why there’s no one doing it in Germany — or probably in France or in different other big European countries. And actually we didn’t really find an answer. But what we found on our way there is that there are some regulatory tweaks for every country that you need to first crack until you can manage to really operate,” he suggests.

“When we went through different topics — groceries, food delivery, beverages — you see almost everything gets delivered instantly. But something that you really need if you are sick and you really don’t want to go out is medicine — so this is something where we said hey this really makes sense.”

It’s worth noting there are a number of telehealth platforms operating private services in Europe that can deliver prescription medicine directly and speedily following a virtual consultation with a doctor — such as Sweden’s Kry.

But — again — Mayd argues there’s room for multiple models to get meds to Europeans’ doors.

“You will see different approaches — one solution is just sending your prescription to a pharmacy so you can pick it up, the other tells you which pharmacy probably has it in stock, the other one tells you where you probably get the cheapest price for you product. But these are all single solutions and we think you need to integrate,” says Pieczonka.

Mayd is gearing up for Germany switching on reimbursement for e-prescriptions next year by launching a service now, ahead of that change — meaning initially it’s limited to delivering only non-prescription items from pharmacy partners. 

So, from today, Berlin residents can kick the tyres of its delivery service to get non-prescription products like bandaids or baby formula delivered to their door.

And while on-demand delivery platforms do exist in some European markets that could speedily deliver the same sort of (non-prescription) stuff you could buy in a pharmacy — Spain’s Glovo, for example, touts itself as a ‘deliver anything’ app — Mayd argues there’s room for a specialist platform for pharmacies given complex and variable requirements around delivering prescriptions.

From January, Mayd will be able to take orders for prescription items — linking patients to pharmacies that will process their prescriptions; pack their medicines for delivery (fulfilled by its e-bike or scooter riding delivery staff who are not gig workers but full time employees); and provide advice to the patient, either via a phone call or in text form through its app based on the patient’s preference.

No prescription will be delivered prior to the patient receiving advice from the pharmacists about how to take the medication and potential side effects, per Pieczonka.

Mayd’s delivery service is starting in the German capital — where he says it has most of the city covered by pharmacy partners (it has around 30 so far) but needs to add more to reach the outskirts of Berlin.

Pieczonka also says Mayd will also be expanding the service to other cities in Germany this year — touting an addressable market of €60BN across the country as a whole.

Its ambitions don’t stop there, though, as it’s eyeing wider European expansion. No decisions have been made on which other regional markets to target yet — but Pieczonka sounds confident the model can scale.

“Our first focus is on Germany because it’s the biggest market in Europe and if we crack this we can also go to other countries. At the end you also see a bigger trend that everyone gets delivered their stuff — so there’s no reason why people in Spain or Italy or France or wherever shouldn’t get [medicines] delivered,” he adds.

Mayd’s business model in Germany is to take a commission from pharmacies on sales of any non-prescription items it routes to them — and a delivery fee (or listing platform fee) for fulfilling e-prescription deliveries.

Berlin-based Mayd has spied an opportunity to build out a medicine delivery platform in Europe which partners with the small-scale pharmacies that tend to be the norm on the continent, capitializing on how the pandemic has generally accelerated demand for on-demand delivery.

The startup, which was only founded at the beginning of this year, has bagged €13 million ($15M) in seed funding from 468 Capital, Earlybird and Target Global to build out its vision of delivering meds to Europeans’ doors fast — within 30 minutes if they’re ordered before noon (or the next day, at a selected slot starting from 8am).

Regulatory restrictions and fragmentation across Europe, with a patchwork of per-country rules around prescriptions, may explain why this use-case hasn’t already been sewn up by a handful of pharmacy or platform giants.

The picture for medicine delivery in Europe is very different vs the US, per Mayd co-founder Lukas Pieczonka, who notes that a patchwork of rules can apply in different countries in Europe — including (still) some limitations on e-prescriptions.

“Most of the US companies they are pharmacies. So they have a pharmacy licence for every state or for a selected number of states and they are operating as a pharmacy. For us it’s not true — we are a platform for pharmacies and for consumers,” he says. “We won’t be a pharmacy. We will heavily work in a very tight way with our partners but we are not a pharmacy. I think this is the biggest difference.”

In Germany, where Mayd is starting out, the country is in the process of gearing up for an e-prescription system that’s due to go live in January — as part of wider moves to digitize healthcare services (such as by bringing in electronic patient records).

Such per country regulations likely (partly) explains the meaty size of Mayd’s seed raise, along with the usual tech and recruitment challenges of scaling an urban logistics app business.

“In Germany there is a different situation who can deliver medicine. At the end the pharmacist needs control of the delivery process which is slightly different from the typical delivery model,” notes Pieczonka. “We set up an infrastructure where [the pharmacist] can really control what kind of rider is now delivering what to whom… If the pharmacist, for example, puts the wrong medicine in the bag or something you should always be able to stop the delivery.

“Secondly there’s a lot of regulatory stuff you need to also implement in your marketplace… so it’s not like you can just add it if you’re a food delivery or whatever delivery. You really need to focus on the specific segment in order to also have the credibility for the pharmacies.”

From next year, Germans will be able to get a digital prescription from their doctor which they can send to a pharmacy to fulfil — with reimbursement of the associated health insurance claim tied in.

Doing e-prescription delivery also means integrating with specific pharmacy infrastructure — which in Germany will involve the use of QR codes.

So again it’s not just another product that can be slung in the backpack of a gigging food delivery rider.

That said, European regulations haven’t been a complete blocker to launching such a model earlier, per Pieczonka. But he argues the timing is right now — with growing digitization of healthcare services and people in the region far more open to app-based delivery and convenience than they may have been pre-pandemic.

“In general we could have done this model two years ago. Actually this was also the first thing we were wondering why there’s no one doing it in Germany — or probably in France or in different other big European countries. And actually we didn’t really find an answer. But what we found on our way there is that there are some regulatory tweaks for every country that you need to first crack until you can manage to really operate,” he suggests.

“When we went through different topics — groceries, food delivery, beverages — you see almost everything gets delivered instantly. But something that you really need if you are sick and you really don’t want to go out is medicine — so this is something where we said hey this really makes sense.”

It’s worth noting there are a number of telehealth platforms operating private services in Europe that can deliver prescription medicine directly and speedily following a virtual consultation with a doctor — such as Sweden’s Kry.

But — again — Mayd argues there’s room for multiple models to get meds to Europeans’ doors.

“You will see different approaches — one solution is just sending your prescription to a pharmacy so you can pick it up, the other tells you which pharmacy probably has it in stock, the other one tells you where you probably get the cheapest price for you product. But these are all single solutions and we think you need to integrate,” says Pieczonka.

Mayd is gearing up for Germany switching on reimbursement for e-prescriptions next year by launching a service now, ahead of that change — meaning initially it’s limited to delivering only non-prescription items from pharmacy partners. 

So, from today, Berlin residents can kick the tyres of its delivery service to get non-prescription products like bandaids or baby formula delivered to their door.

And while on-demand delivery platforms do exist in some European markets that could speedily deliver the same sort of (non-prescription) stuff you could buy in a pharmacy — Spain’s Glovo, for example, touts itself as a ‘deliver anything’ app — Mayd argues there’s room for a specialist platform for pharmacies given complex and variable requirements around delivering prescriptions.

From January, Mayd will be able to take orders for prescription items — linking patients to pharmacies that will process their prescriptions; pack their medicines for delivery (fulfilled by its e-bike or scooter riding delivery staff who are not gig workers but full time employees); and provide advice to the patient, either via a phone call or in text form through its app based on the patient’s preference.

No prescription will be delivered prior to the patient receiving advice from the pharmacists about how to take the medication and potential side effects, per Pieczonka.

Mayd’s delivery service is starting in the German capital — where he says it has most of the city covered by pharmacy partners (it has around 30 so far) but needs to add more to reach the outskirts of Berlin.

Pieczonka also says Mayd will also be expanding the service to other cities in Germany this year — touting an addressable market of €60BN across the country as a whole.

Its ambitions don’t stop there, though, as it’s eyeing wider European expansion. No decisions have been made on which other regional markets to target yet — but Pieczonka sounds confident the model can scale.

“Our first focus is on Germany because it’s the biggest market in Europe and if we crack this we can also go to other countries. At the end you also see a bigger trend that everyone gets delivered their stuff — so there’s no reason why people in Spain or Italy or France or wherever shouldn’t get [medicines] delivered,” he adds.

Mayd’s business model in Germany is to take a commission from pharmacies on sales of any non-prescription items it routes to them — and a delivery fee (or listing platform fee) for fulfilling e-prescription deliveries.

Making sure mental wellness is part of your routine can be difficult, especially if you are already busy and stressed. MindLabs wants to make it easier with a combination of on-demand or live video classes and community features. The company announced today it has raised a $3.5 million seed round, almost eleven months after its pre-seed funding.

The seed round was led by PROFounders Capital, with participation from Slack Fund; Sky executive chairman and former chief executive officer Jeremy Darroch; and returning investors Passion Capital and Seedcamp. The timing of the announcement comes three days before World Mental Health Day on October 10, to raise awareness of mental health issues and increase access to care.

The new funding will be used to hire for MindLabs’ product and engineering, content and market as it prepares for its public launch next year.

MindLabs was founded last year by Adnan Ebrahim and Gabor Szedlak, who previously launched and ran CarThrottle, an automotive site and community that was acquired by Dennis Publishing in 2019. When TechCrunch first talked to the founders last year, they said they decided to focus on mental health for their next startup because of the rapid increase in depression, especially during the COVID-19 pandemic.

Over the past year, MindLabs has hired leaders for its engineering, production and marketing teams, and built out its beta app, which now has 16 instructors. The startup’s platform is slated for a public launch in the first quarter of 2022. Ebrahim told TechCrunch that MindLabs currently has thousands of users on its waitlist, thanks in part to the growth of its Instagram account, which has almost 60,000 followers.

MindLabs will be available first in the United Kingdom, before launching in the United States. Ebrahim says it plans to expand into non-English speaking countries, since the team believes the platform is easily translatable.

Its app now has over 100 on-demand videos created by mental wellness, psychology and neuroscience professionals, and will also host daily live videos classes from its studio in West London. One of its instructors is Richie Bostock, AKA The Breath Guy, who is a meditation and breathwork expert. Community features were built in, partially in response to the isolation people have experienced during the pandemic.

MindLabs also eventually plans to release hardware, like an EEG headband, to track health indicators. Ebrahim said MindLabs is launching with an app-first strategy before moving into wearables, with affordable subscription plans for classes so they can reach as many people as possible.

“We’re still extremely excited about tracking biomarkers of the mind, such as EEG, heart rate and breathing patterns, through existing and our own wearables,” he said. “We believe this will help us build a more accurate, real-time picture of how our users feel, and therefore be able to serve them with the most relevant video classes to help improve their mood.”

London-based Habitual, a healthtech startup which offers a weight loss program aimed at people with type 2 diabetes (or prediabetes) that combines “evidence-based” food replacement with digital support to help people manage and even reverse the condition (so they can be medication free), has closed a $2.3 million seed round.

The round was led by Berlin-based Atlantic Food Labs, with existing investors Seedcamp and MMC also participating. Oxford Seed Fund, which is an initiative of the Entrepreneurship Centre at Saïd Business School, University of Oxford, also participated — and the round is Habitual’s third round since it was founded back in September 2019, including a pre-seed earlier this year to fund a soft launch. Its total raised to date is just over $3M.

Habitual’s program involves a period of total food replacement — when it supplies users with all their daily meals in nutritionally controlled, packet-form (there’s a choice of flavored porridges, shakes and soups).

For the food replacement product, Habitual says it worked with a product development consultancy that had previously done development work for the European Soylent-rival Huel to develop the formulations.

Its companion digital program is designed to wrap around and support patients throughout their dietary transitions — including guiding them through the reintroduction of healthy whole foods, with the app giving them tools to track their weight and mood, and access resources and digital coaching.

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“We use the same nutritional framework as was used in DiRECT [trial] (and other total diet replacement studies) — that is, three months of total diet replacement followed by a slow reintroduction of whole foods back into the diet, during which time we help patients to retrain around healthy nutritional, mental, and physical habits,” says co-founder and COO Napala Pratini.

“The main difference… is that we guide patients through the programme completely digitally, as opposed to via in-person of telemedicine appointments.”

Per Pratini, Habitual’s digital intervention consists of three key components — first, “evidence-based” daily behavior change lessons and exercises, which she says run the gamut from CBT to nutritional education to support users as they re-introduce whole foods; second, the app provides personalised daily tracking (through self reporting) to help patients monitor progress over time; and lastly users can access the startup’s patient care team and “bespoke virtual peer groups”.

Health problems associated with obesity and poor diet are a huge and growing problem across most parts of the world, often linked to heavily processed, sugar-laden foods that have been staples on supermarket shelves in rich, Western countries for decades — but which are increasingly finding their way into developing countries, too.

In the West, over the past decade or so, a number of digital health startups have sprung up on both sides of the Atlantic aiming to use technology to help tackle this problem — such as the likes of Livongo, Liva Healthcare, Omada, Oviva (which recently raised an $80M round), Second Nature (formerly OurPath) and Sequoia-backed Virta, to name a few.

There are also general weight loss platforms, like Noom. And — more recently — increasingly specialized plays, such as YC-backed Fella (which, as the name suggests, does targeted obesity support specifically for men).

But the opportunity to provide digital support in the area of diet and health is huge, with different approaches also likely to work for different people (or indeed, different health conditions) — so it’s unlikely to be a winner-takes-all scenario.

The cost of diabetes-related healthcare has also been predicted to pass $1 trillion per year by 2025 by some estimates — so even just capturing a tiny fraction of this market could sum to a sizeable business.

“We are tackling the root cause of the biggest problems facing modern healthcare systems, and while US companies have raised and been valued in the billions, there is so much room to do better for patients,” argues Pratini.

She says the London-based startup has “global ambitions” — and wants to take on US giants with what she describes as “a more empathetic, patient-led model of diabetes care”.

During a private beta of Habitual’s program which involved 30 patients, Pratini says users saw an average weight loss over the 3 months of 17kg — a little over the amount of weight that she says has been shown to be “necessary” to reverse type 2 diabetes in a majority of people.

“As you say, some people will of course need to do shorter or longer periods [of total food replacement] to achieve their goals, and we support patients in doing that,” she adds.

Pratini, who has a marketing background, says she and her co-founder, CEO Ian Braithwaite, a medical doctor with a background in digital health startups and clinical practice, met working alongside the DiRECT team — “and are therefore very familiar with the research”.

Habitual will be putting its product through its own peer-reviewed trials “in the next year”, she also tells TechCrunch.

The startup has started with a direct-to-consumer program — meaning individuals are referring themselves and it’s charging these users a fee (£39/week or £139/month for 6 months — “this includes all of a patient’s food for 3 months, and about half of their food for the second 3 months”).

But it’s hoping to be able to work with payers like the UK’s National Health Service in the future, as well as self-insured employers and insurance companies (the latter being the dominant model in the US).

“We have taken the direct to consumer route to begin with because it has enabled us to start building evidence and scaling more quickly than we would be able to whilst relying on NHS procurement,” notes Pratini.

“The NHS is already doing trials of similar programs, however these pilots only reach a tiny fraction of the UK’s Type 2 diabetics. We expect these programs will be rolled out on a larger scale in a few year’s time, at which point we’ll have a significant amount of evidence under our belt to be able to successfully bid for these NHS tenders,” she adds.

A UK law firm is bringing a class-action style claim over a patient health data scandal that dates back to 2015 and involves the Google-owned AI company DeepMind, after it was quietly passed medical information on over a million patients by an NHS Trust as part of an app development project.

Law firm Mishcon de Reya announced the legal action today, saying a “representative action” has been filed on behalf of a UK citizen, called Mr Andrew Prismall, and the approximately 1.6M others whose confidential medical records were obtained by DeepMind/Google without their knowledge or consent.

Google and the Royal Free NHS Trust have been contacted for comment on the lawsuit.

Last month TechCrunch reported that Google was pulling the plug on the clinician support app, Streams, which was developed by DeepMind and the London-based Royal Free NHS Trust starting in 2015.

The Streams app was rolled out for use by clinicians at the Royal Free and a handful of other NHS Trusts. However the Royal Free was sanctioned in 2017 by the UK’s data protection watchdog, the ICO, for breaching data protection rules when it passed patients’ sensitive medical information to the Google-owned company during the development phrase of the app.

In a press release today, Mishcon de Reya described the lawsuit as an “important step in seeking to address the very real public concerns about large-scale access to, and use of, private health data by technology companies”.

“It also raises issues regarding the precise status and responsibility of such technology companies in the data protection context, both in this specific case, and potentially more generally,” the firm added.

During the height of the COVID-19 crisis last year, the UK government inked a number of health data processing contracts with tech giants including Google and Palantir — and those deals have also faced concern and criticism over a lack of transparency.

The government is also consulting on whether to reduce the level of data protection afforded to UK citizens, as it seeks to diverge from the European Union’s gold standard of privacy by design and default, set out in legislation such as the General Data Protection Regulation (GDPR).

In a statement on why he’s taking the legal action, Prismall said: “Given the very positive experience of the NHS that I have always had during my various treatments, I was greatly concerned to find that a tech giant had ended up with my confidential medical records.

“As a patient having any sort of medical treatment, the last thing you would expect is your private medical records to be in the hands of one of the world’s biggest technology companies. I hope that this case will help achieve a fair outcome and closure for all of the patients whose confidential records were obtained in this instance without their knowledge or consent.”

Mishcon partner Ben Lasserson, who is leading the case, added: “This important claim should help to answer fundamental questions about the handling of sensitive personal data and special category data. It comes at a time of heightened public interest and understandable concern over who has access to people’s personal data and medical records and how this access is managed.”

A spokeswoman for Mishcon de Reya confirmed to us that it has issued the claim in the UK High Court.

Asked about whether the claimants is seeking financial damages and/or asking for the data to be deleted she said she was unable to provide any more information at this early stage.

Most of the NHS Trusts that inked five-year deals with DeepMind to use the Streams software — contracts which subsequently transitioned to Google’s health division, after the company took over DeepMind Health in 2018 — told us they had terminated their arrangements when we asked them about their use of the app last month, as it emerged Google was pulling the plug on the UK app following news of an internal reorganization of its health efforts.

However the Royal Free Trust claimed it would continue to use Streams, despite Google’s announcement that support was being withdrawn — raising questions over how the Trust would ensure the app’s security was kept up-to-date and which divisions within Google would be responsible for handling related service level agreements, going forward, after the tech giant’s internal reorg of its health, wellness and AI efforts.

Withings is launching the ScanWatch Horizon, a dolled-up version of its ScanWatch inside the body of a diving watch. Horizon comes in a bigger, 43mm case size, but is otherwise the same device we already think is the best hybrid on the market. That includes the built-in ECG, blood oxygen sensor and sleep apnea tracking, as well as the usual activity and sleep-monitoring features. You’ll also get the same pair of sub dials, one with a small digital screen for notifications, the other an analog activity counter.

At an event in Paris, we got a chance to see the ScanWatch Horizon and try it on, though it was a non-functional prototype. It’s certainly as pretty in person as the photos show, and with the steel quick-release band, feels nice considering the price. For the first time, Withings will sell the ScanWatch Horizon at jewelers on top of other retail locations.

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The company told Engadget that the chunkier Horizon model has a more “masculine” design for larger wrists, with only a 43mm model available. The original ScanWatch, by contrast, came in sizes ranging from 38mm to 42mm.

Sadly, the beefier body and higher price hasn’t added anything to the feature list, and so there’s no GPS on this watch unless your phone comes along for the ride. And, if we’re nit-picking, we can say that while it’s dressed to impress as a diving watch (with an accurate laser-engraved rotating bezel and Luminova watch hands) water resistance is limited to 10ATM. That allows for snorkeling, water activities and some scuba diving, but it isn’t much compared to most serious diving watches.

That said, the smartwatch world is crying out for anything that matches premium diving watch styling with a hint of smarts. It can’t be that TAG Heuer’s Connected is allowed to become the default in this market by default, especially since it’s running, you know, Wear OS.

Steve Dent/Engadget

Withings told Engadget that FDA approval of its ECG health sensor is holding back the ScanWatch Horizon’s release in the US, but it’s hoping to bring it stateside by the end of the year. That’s also why the original ScanWatch has yet to go on sale in the US, in case you were wondering.

As for when you can get one of these on your wrist, the ScanWatch Horizon will first launch in the UK from September 29th, priced at £499.95 / €499.95. Buyers will be able to choose the Blue or Green face color, and both models will ship with a quick-release stainless steel and an FKM rubber band (for swimming). It also arrives today in France and Germany, and you can expect it to pop up a bit later elsewhere in Europe.

Steve Dent contributed to this report.

Editor’s note: This article originally appeared on Engadget.

Continuing research by Stanford and Apple from the 2017 Apple Heart Study, which managed to enrol over 400,000 participants and became one of the largest studies of its kind ever performed, has shown that the Apple Watch is capable of detecting other types of arrhythmic heart beat irregularities in addition to atrial fibrillation (AFib). Apple Watch currently offers potential atrial fibrillation detection and notifications as one of its core health features, introducing it to the device with its Series 4 update which added an electrocardiogram (ECG) sensor.

The results of the Apple Heart Study proved the science behind that feature, which Apple itself has always positioned as a way to be more aware of your health and potential conditions that may affect your heart health, rather than any kind of very accurate predictor or actual medical device. But over the years there have been many verified stories of Apple Watch users who credit the AFib notification feature as the reason they were able to catch an otherwise asymptomatic issue early thanks to follow-up care from a doctor.

This additional research from the Heart Study dives deeper into the data gathered to show that for 40% of participants who received a notification about a potential irregular heartbeat from their Apple Watch, but for whom follow-up testing with a medical ECG didn’t show AFib, there were other arrhythmias present. These included premature atrial complexes, premature ventricular complexes, and non-sustained ventricular tachycardia. These are fairly common, and often identified by those who experience them as heart palpitations, but premature complexes in particular could be an indicator of other underlying problems.

The new study, published in the American Heart Association’s Circulation Journal, also found that nearly a third of participants who had no AFib detected using the ECG patch after receiving a notification were in fact diagnosed with atrial fibrillation by the end of the Heart Study, indicating that the Apple Watch may have been detecting cases early which the subsequent ECG patch had missed. That would suggest a higher efficacy for the Apple wearable than shown in prior studies.

There’s always a lot of speculation about potential new sensors and technical capabilities being introduced to new generations of Apple Watch, but we’ve already seen that research from large-scale studies like the Apple Heart Study, and the Apple Heart and Movement Study can provide a pathway to new capabilities using existing hardware and sensors, too. Apple Watch showing promising results in terms of detecting other heart arrhythmias might just fit into the category of explorations that find their way to more Health features in future.

Amazon is introducing two new services tied to user health and fitness, and its Halo personal health devices. They include Halo Fitness, a new service for interactive home video workouts that looks a lot like Apple Fitness+, and Halo Nutrition, a personalized, guided meal planner.

Both of these services will be included as part of Amazon’s Halo membership for users of its Halo line of fitness trackers, which include the new Halo View activity tracker that adds an OLED display. The Halo subscription costs $3.99 per month after a six-month free trial bundled with the hardware, and Amazon says it’ll include both of these new features starting later this year for Fitness, and in January 2022 for Nutrition.

Halo Fitness offers “studio quality workouts” led by “industry experts,” and offers real-time display of metrics like heart rate and heart rate intensity zone as captured by the Halo fitness bands. The workouts include coaches like Michael Hildevbrand, Elana Cheung, and Elizabeth Andrews, and it will offer cardio, strength, yoga, outdoor and mobility classes in terms of types of workouts.

Halo Nutrition will offer recipe discovery and meal planning, with options to create tailor-made menus based on dietary preferences and requirements, or pre-curated menus for specific diets including ‘classic, keto, mediterranean, nordic, paleo, vegan and vegetarian. At launch, Amazon says it’ll have a library of over 500 recipes from partners including Whole Foods and WW, with integration with Alexa Shopping list for finding ingredients.

There are few challenges messier and more fraught than the U.S. healthcare system, but a growing number of startups are looking at ways to address shortcomings in standards of care through tech. We had three such companies share our virtual stage at TechCrunch Disrupt 2021 this year, including Cityblock Health president and co-founder Toyin Ajayi, Forward CEO and founder Adrian Aoun, and Carbon Health‘s Eren Bali.

Let’s just say this conversation got heated — fast.

The main point of contention arose around defining what constitutes customer-centric healthcare and Aoun’s stance that, regardless of what else is involved in a company’s approach, starting from a point of working with insurers disqualifies a company from making any consumer-centricity claims.

“We keep saying that these companies are kind of consumer-centric,” Aoun said, referring to the panelists. “But in many ways I think one of the things that you realize is that when you get in bed with the insurance companies, which, whether it’s a Carbon or a Cityblock, at the end of the day, [if] you get in bed with the insurance companies, unfortunately, your incentive is basically not to go build a good consumer product.”

“Your incentives are actually not the right thing — they’re not what the consumer needs,” he added. “So at the end of the day, you’re [referring to Eren and Carbon] launching a scheduling feature. We’re launching a heart health program that eliminates high blood pressure for 40% of our members. You’re launching a new way to bill; I’m launching cancer prevention.”

Ajayi took issue with the binary Aoun was trying to establish and explained why it’s actually not such a clear-cut division between working with insurers and having a real and meaningful focus on patient outcomes.

“Adrian has said, either you get reimbursed by insurance, or you build a consumer or patient-centered company. And you know, in parentheses, that only very wealthy people can afford. What we found is actually that’s not binary; there is another path, which is partner with insurers, but take risk on the total cost of care and outcomes. So we do not bill for a community health worker coming to your home, holding your hand, telling you that you matter and helping understand what goes on in your life. But we absolutely are incentivized to do that and to innovate in that space, because that allows us to earn the right to provide healthcare to people that make them healthier.”

Every year, more than 100,000 people in the United States wait for an organ donation. More than a dozen people will die each day still waiting. Such is the brutal math and the necessary optimism required to work in the organ procurement world.

For the past several decades, a private network of now 57 organ procurement organizations (OPOs) have sprouted up, all broadly affiliated with UNOS, the United Network for Organ Sharing, a non-profit whose goal is to match donated organs with potential recipients.

It’s a unique facet of the medical world, and also one that is surprisingly more like a tech startup than might first meet the eye. From early beta products to a much more professional and modern tech stack, the network and its affiliates have strived to improve the speed and reliability of the organ transplantation process.

I wanted to look at some of the organization’s most recent initiatives, including improved logistics and planning infrastructure, while also exploring some of the more science fiction projects: xenotransplantation, drone-delivery systems, and organ viability platforms. So I interviewed a number of folks at both UNOS and two OPOs to hear what’s cutting edge, and what remains a dream for the future.

A guy with a phone number

Joel Newman, senior communications strategist at UNOS, where he has worked nearly three decades, said that “transplantation has always been unique in the sense that everybody’s got to collaborate and communicate in real time — not always with people they know.” Perhaps surprisingly given the life-and-death stakes of organ transplantation, “a lot of those arrangements were shockingly informal.”

In fact, they were so informal in the early years, that matching donors to recipients was operated out of a voicemail inbox.

Howard Nathan, the current president of organ procurement organization Gift of Life (and the longest serving president of any OPO, having taken the role in 1984), said that one man, Don Denny, ran much of the collaboration infrastructure in the early years as organ transplantation became more viable in the 1980s.

Denny, who moved to Pittsburgh in 1977, created his own status system for patients from one to four, with one indicating the most urgent organ needs (the rating system is the opposite today). “He’d record every day this message” on his voicemail, Nathan described, “and you listened to this recording.” From there, “you’d look at your donor in the ICU where you had permission from the family, and if it’s a match, you’d call.” Nathan says that Denny coordinated 2,700 transplants over 4.5 years, all from his recorded voicemails and phone calls.

UNOS was formed in 1977 and eventually incorporated in 1984. By 1986, it had developed more computerized systems to handle the organ matching process, using the latest communications technology: faxes. Rick Hasz, who is today vice president of clinical services at Gift of Life and will succeed Nathan as president in 2022, said that the technology wasn’t all that reliable. “When I started we had thermal paper faxes,” he said. “If you didn’t allocate quickly, then that thermal paper dissolved and you’d lose the list.”

Unsurprisingly, UNOS has continued to evolve its technology over time with the needs of organ donors, donor hospitals, organ recipients, and transplantation centers. It relies on a web-based application, and even has a mobile app now.

Amy Putnam, director of IT customer advocacy at UNOS, said that one big breakthrough came with a mobile app to reduce errors. “Back in 2012, we worked on a change called TransNet, and TransNet is a mobile application, it’s built on iOS and Android, that allows the OPOs to electronically package and label organs,” she said. “As you can imagine at three in the morning, most people’s handwriting is not very legible, and you end up with a lot of data entry errors, and that’s where TransNet really helped.”

The real gain of building the system though was being able to work collaboratively with all of the organization’s OPO affiliates and refine processes based on feedback from all of its users.

Building the Expedia for organs

Image by aydinmutlu via Getty Images

Calls and communications are key for coordinating transplantations. Organ donations are typically sudden, can happen almost anywhere, and OPOs have just hours to get the organ from the donor hospital into a recipient patient at a transplant center. Not only that, but which patient waiting on a list has to be determined with extreme speed, with potentially dozens of transplant centers interested in a particular organ. Processing all those requests, in real-time, is the huge emphasis of UNOS’ modern tech stack.

Newman explained some of the intricate work that is involved. “Kidneys can often be transplanted within about 24 hours. Once they are recovered, obviously shorter is better and probably most of them go in 12 hours or less,” he said. “When you’re looking at livers and pancreas, it’s probably ideally less than eight hours. Hearts and lungs go down to about four to six hours.” The time that an organ is viable after losing blood supply is known as the ischemic time.

Over the past few years, UNOS has developed much more elaborate tracking systems to understand where organs are. Julie Kemink, chief clinical officer at LifeSource, an OPO, said that “what you see now is similar to what you might see with an Amazon package… you see that it is shipped… but you don’t necessarily know” where precisely it is, she said.

However, new updates to UNOS’ infrastructure are starting to deliver real-time location information for every organ. “Now it’s more like an Uber — you can see where it is physically at all times,” she said.

Adding GPS coordinates for each organ sounds like a simple proposition, but required immense coordination. Since donor hospitals, organ procurement organizations, and transplantation centers are all different entities, defining a universal standard for location was challenging. Furthermore, since organs tend to arrive quite randomly, having the right equipment and trackers on hand in every part of the country proved its own hurdle.

Now with better logistics information, transplant surgeons can get real-time updates on organ arrival times. If an organ is traveling by plane in the cargo hold and the plane arrives at an airport early, doctors can be notified that it’s running ahead of schedule and prep a patient earlier. Similarly, if vehicle traffic is delaying an organ’s arrival, transplant centers can push back a patient’s pre-op procedures.

With more data available, UNOS is now exploring a “travel app” or what Putnam dubbed a kind of “Expedia for organs.” She said, “It allows the OPOs or transplant hospitals to enter in some specific information about the donor hospital [and] the recipient center, and it will give them options, it will show them flight options, it will show them travel time if they’re going to travel by car.” She said the app, which is entering a pilot phase, could eventually allow organs to be fully ticketed right in the app experience.

That infrastructure is critical, because UNOS has been updating how it defines distance for organs. For decades, the organization and its OPO affiliates used a regional boundary system — organs in, say, Minnesota would be given first to recipients in Minnesota, and then if none could be found, they would be offered to nearby regions and so on.

That was a simple system, but one that could be taken advantage of, particularly by the wealthy. More than a decade ago, a controversy erupted when Steve Jobs received an organ transplant in Tennessee, despite not living in the state. He did so through a process then known as “multiple listing” — for those with the means, a recipient could register on as many regional organ donor waiting lists as possible. If a match was found anywhere nationwide, the recipient could quickly charter a private plane to wherever the organ was and essentially cut the time they waited on a list.

Now, UNOS uses a distance algorithm that’s based on actual radius, and not just arbitrary regional boundaries. That still leads to some incongruities. Kemink of LifeSource, which is the OPO serving the Minneapolis regional area, said that “being in Minnesota — we are in proximity to both coasts… so we do have opportunities to place organs throughout the country.” That’s unlike the options available for the coasts. “In California, getting a heart from New York is basically impossible,” she noted.

In addition to better logistics, UNOS has optimized its platform for integration. “As you could imagine, most people hate having multiple usernames and passwords, they hate multiple solutions. So the biggest thing was integration, give us integration,” Putnam said about recent upgrades.

Part of that integration story was adding more ways to upload patient data and imagery files. Now, doctors can “upload and actually see the coronary angiography to see that [a heart] is the right match for a recipient,” Kemink said. That improves decision times on offers, and ultimately increases the viability of an organ transplant.

The IFTTT of organs

Illustration by SIphotography via Getty Images

As organ transplantations have become more frequent — 39,000 were conducted in the United States according to government data — there are increasingly large datasets available to finely tune the network’s allocation strategy and ultimately improve the number of organs that are successfully transplanted.

“Right now, we’re working on a project to introduce predictive analytics into the organ offer process, and looking at some analytics related to what is the probability of survival if they were to accept this organ,” Putnam said. If they decline an organ, then “what’s the probability and the timeframe until they will get a similar or better organ?” UNOS is currently working on a pilot to get feedback from its clients on these changes, and also ensure that the explainability of the algorithm is extremely clear given the highly sensitive nature of organ donations.

The network has also been piloting since last year a feature it dubs “offer filters,” which transplant centers can upload to the network’s platform to automate more decision around potential organ matches. Putnam said, “What we did is we looked at kidney acceptance data, historically, and said, ‘Are there offers that we know there’s no way a transplant center would ever accept?’”

Newman of UNOS said that “there have always been some screening criteria that centers could put in, but this allows actually a little bit more filtering of, ‘You know it’s not like I would never accept a donor older than 70 years old, but if it’s gonna be a donor older than 70 years old and it’s gonna take more than six hours to get here, I’m not interested.” UNOS expects a national rollout sometime later this year.

The future of organ donations

As critically important as the organ procurement process is, much of the gains the past decade have ultimately been a function of better IT applications and implementations. The big question a lot of startup founders and venture capitalists are interested in is the viability of “moonshot” ideas that can radically change organ availability for patients in need.

One project, using drones to deliver organs, has already been trialed. Nathan of Gift of Life said that “right now, the drone thing has been done — they’ve done one case” and also noted that “there is another group in Maryland that is experimenting with it too.” He’s somewhat skeptical about the technology given the distances organs have to travel (potentially hundreds of miles) and the potential for damage to the organ itself. “You don’t want to put the organ at risk,” he said.

Then there are a set of technologies including cryogenics and warm profusion which are designed to increase ischemic time (or eliminate it entirely), giving organ procurement organizations more time to get organs to the patients most in need of them. Several devices and systems are running through FDA trials now, and are expected to arrive and be put into practice over the course of the next decade.

Kemink of LifeSource pointed to blood-type matching and age as two criteria that could improve organ distribution with better organ viability technologies. “AB blood type is the most uncommon blood type, so there aren’t that many patients who are waiting for that blood type,” she said. At any given time, “there might not be a recipient that fits,” and so cryogenics could keep the organ “on ice” until the right patient shows up who needs it. Similarly, donated organs need to match the size required by the recipient. “You can’t take a heart from a 12-year-old and put it in a 70-year-old,” she said, since the sizes wouldn’t match the bodies. “We could preserve it until the person that needs it is there … that would be another tremendous advancement.”

There have also been advances in procuring organs from patients who die from circulatory death, in what are known as DCDs, or donations after circulatory death. Nathan said “there are 2.8 million people who die every year in this country, [and] only about 20,000 of those people are medically suitable to be an organ donor.” That’s one reason there is a huge wait time for organs.

Hasz noted that advances for procuring organs in these contexts have increased the likelihood that viable organs could be found. “Up until the last couple of years, nothing really changed: it was quite limited to liver and kidneys,” he said. But “in the past few years, the opportunity of helping more people with heart and lung transplants” arose, and “200 hearts have been used.” Ultimately with these new technologies, “we think it can expand the donor pool by 30% for DCD hearts.”

Finally, we get to what is known as xenotransplantation, or moving organs from animals to humans. Such experiments have gone on for decades, and progress has been somewhat elusive. Hasz said “10-15 years is always what you hear about xenotransplantation.” That said, he notes that new technologies like CRISPR have allowed for more progress in the space in recent years, potentially opening a pathway for animal organs to solve the shortage of human organs available.

For all the changes and new technologies though, the basic equation of organs in the United States remains the same: people need to check yes in order for lives to be saved. “The biggest thing that we need is more people to say yes to donations,” Kemink said. “Nobody gets a transplant unless people say yes to donation.” Today, roughly half of Americans are organ donors, and solving that isn’t about technology so much as about reminding people of the power of life — and what they can offer others.

A number of sexual health startups have spun up in recent years offering men discreet help with the awkward issue of erectile dysfunction. Companies like Numan and Roman. But ‘help’ in this context usually means making it easier to get hold of drugs like Viagra.

UK-based startup Mojo has been taking a different tack. It’s built a subscription service to support men’s sexual wellbeing by providing on-tap access to dedicated therapies — partnering with professional psychosexual therapists to provide online courses that are billed as offering a longer term solution to male sexual health problems vs just popping some blue pills.

This approach means Mojo sits within a wider digital health trend where the smartphone in the pocket is being appropriated by app makers to deliver targeted, non-pharmaceutical support — be it for insomnia, dietary needs, musculoskeletal disorders, mental health or indeed sexual wellbeing. (The latter category includes dedicated apps for women, too.)

The idea driving all of these startups is to offer people a viable alternative to Big Pharma. (And hopefully eat some of the drug companies’ lunch in the process.)

Mojo’s support platform is geared towards a spectrum of issues that can affect men and have links to their sexual wellbeing — with digital programs not just geared towards with erectile dysfunction but other sexual problems like porn addition or anxiety more generally.

So it could be an interesting ‘way in’ — to encourage men to explore wider psychological issues by accessing support services. (Men are a notoriously difficult group to get into therapy but erectile dysfunction is likely to be a trigger for a lot of therapy-shy individuals to seek support.)

Mojo’s quarterly subscription service (costing £49/$68 every three months) provides access to professional resources that Mojo bills as “unobtainable for most”. It also describes its app as a “virtual coach” — saying it’s aiming to “encourage men to reclaim their erections and have great sex without resulting to a medication first approach”.

The digital support package includes video courses and exercises, therapy podcasts and meditations, and live events — including the chance to connect directly with Mojo’s panel of sexual health experts and the wider community of men using the app. A dedicated community reduces the stigma that men may feel around discussing intimate health issues — since other users are likely to be experiencing similar problems.

The 2019-founded startup says it’s signed up “close to” 50,000 users across 36 countries so far.

It’s announcing seed funding today to step on the growth gas.

The £3.25 million ($4.4M) round is co-led by London early stage fund Kindred Capital and Octopus Ventures. Angel investors in the round include some familiar names in the European startup world, including Tom Blomfield (Monzo), Julien Callede (Made.com), Ian Hogarth (SongKick), Freddy Macnamara (Cuvva), Alex Rose (Let’s Do This) and Errol Damelin (Wonga).

Commenting on the seed funding in a statement, Kamran Adle, health investor at Octopus Ventures, said: “Taboo areas within health continue to be a key area of interest for us, as there is often high latent demand due to decades of underinvestment. Men’s sexual health is a perfect example of this, creating a huge opportunity for Mojo to challenge the stigma and move beyond pills to a much broader, sustainable and scalable solution.”

In another supporting statement, Maria Palma, general partner at Kindred, added: “We deeply believe that the strong founding team at Mojo can redefine the conversation around male sexuality and vulnerability. It is clear from their early evangelical user base that they have created a product which resonates with men all over the world and helps them transform their confidence, relationships, and their everyday lives.”

Smart fitness gear is often limited by being static and non-portable. (And, well, eye-wateringly expensive.) Think Peloton‘s stationary bike for spin classes or wall-mounted strength training rig Tonal. Great if you’re at home and can afford to shell out thousands on a fancy home gym, but what if you want to take your workout with you wherever you go?

Meet Straffr, a German startup that’s exhibiting at the TechCrunch Disrupt Startup Alley this week. The company sells a smart fitness band that you can just pop in your backpack and take with you when you hit the road.

Originally opting for a crowdfunding route via Kickstarter last year, the hardware startup has gone on to sell “a few thousand” bands since getting the product to market in March this year. They’ve also bagged backing from business angels and have just closed a second seed round with an international investor as they gear up to expand their fledgling fitness business.

Straffr’s smart resistance band, which comes in either medium or strong strength grades, connects to the companion app using Bluetooth, and starts tracking as you soon as you start stretching and flexing — providing feedback on your training session, not just on reps but on “quality” of exercise, per CEO Stefan Weiss.

The whole band is actually a sensor — made of an expandable rubber that’s electrically conductive. Straffr’s team developed the material and has some patents on it.

“It’s really hard to find and develop a material that stretches over 200% or 300%… and not break and not measure anything,” Weiss tells TechCrunch. “When you stretch [the Straffr fitness band] the electrical resistance changes and therefore we can say how much you’ve stretched the band for a specific exercise.”

Anyone who’s tried to do strength training using a (non-smart) resistance band knows it can be pretty tricky to keep focused and engaged without professional guidance. Basically it’s hard to know if you’re performing the movements in an optimal way or just mindlessly twanging a piece of rubber. So a sensing element looks like it could add a lot of value to this particular bit of fitness kit.

Straffr’s smart band clocks your reps, power and velocity as you pull, with the app providing real-time feedback through the workout — offering verbal cues if you’re pulling “too fast” or nudges to keep things “slow and even.” It’ll also show you overall results of the workout if you’re a fan of fitness stats.

The app features a selection of workout videos which let you follow along to pre-recorded fitness band sessions, such as HIIT-focused workouts, total body strength training or quick home-office exercises.

Image credits: Straffr

Weiss says the startup is building a premium on-demand offer, too — and has recently onboarded five personal trainers who it wants to offer its users one-to-one training sessions on-demand. That will be for a future Pro feature. The basic app is free, as the startup is charging for the hardware.

Straffr’s band costs just over $100 (€99.99), which is very pricey if you’re comparing it to a non-smart alternative (a basic resistance band can cost just a few dollars). But that’s a fairly poor comparison, because here you’re getting a whole fitness package versus just a piece of elastic. So those extra dollars are for relevant exercise content and in-app personalization along with workout quantification and the added motivation of live feedback.

It’s also worth noting that Straffr’s smart band is considerably cheaper than shelling out for a Peloton or other high-end connected home-gym kit, which is now aiming to lighten people’s wallets by targeting their workouts.

So, seen from that perspective, Straffr’s spin on smart fitness kinda looks like a bargain.

Typical buyers so far tend to be either fitness-focused men who are very into the ‘quantified self’ trend, per Weiss, or middle-aged women wanting an alternative to fitness classes at the gym. But a humble (but smart) fitness band really could offer something for everyone.

“Where really we see a future of training with resistance bands is with personal trainers directly,” Weiss adds. “One-on-one digital training, on-demand, with personal trainers, with pro athletes, with Olympians that talk you through the whole workout routine, what it does, they’re training with you, it’s sweaty training, it’s motivating for people.”

Still, if resistance band workouts really aren’t your jam, Straffr does have plans to develop additional bits of a smart fitness kit. Although Weiss won’t be drawn on exactly what other connected hardware they’re cooking up.

“We do have a product in the pipeline now that we’re developing internally right now — and we’re really excited about it,” he says, adding: “I can say it’s not going to be just a jumping rope which counts.

“For us it’s always the combination of functional, really portable training with the component of tracking quality — the quality of your training. Like how good are you? Are you actually effective? Because if you’re just counting reps and steps and stuff there’s obviously a good motivational aspect to it… but we want to also see are these reps really good, are they good quality, are you doing the best you can for the condition you’re in right now?”