Accelmed, a group of funds that invests in health tech companies, announced Monday that it is launching a new, nearly $100 million fund to invest in early-stage, pre-revenue medical devices and digital health startups in Israel and around the world.
This is the fourth fund launched by Accelmed, which currently manages more than $300 million. The new fund will be led by Dr. Irit Yaniv and Amir Blatt, both partners at Accelmed. Dr. Yaniv said that the fund will help to alleviate the problem that device entrepreneurs face in raising capital for their novel devices, in a news release. Blatt said that the fund will invest in device companies “in advanced clinical trials, nearing FDA approval, and after first-in-human trials” whereas in digital health, the fund will invest in “companies in initial commercialization stages in the US, be it with hospitals or insurers.”
The fund expects to make an average investment of $8 million to $10 million per startup, including follow-on investments.
Accelmed comprises of two entities:
Accelmed Partners – a U.S. -based private equity fund focused on health tech that does buyout and growth investments in commercial-stage companies.
Accelmed Ventures – an Israel based venture fund that invests in pre-commercialization health tech companies.
Since Aceelmed’s founding in 2009 by Dr. Uri Geiger, founder and managing partner and Mori Arkin, it has funded about 20 healthtech companies, of which several have been acquired.
These include Edge Medical Devices that was sold in 2011 to Claymount, which was then acquired by Varian Medical Systems; NLT Spine was sold to Seaspine Holdings in 2016; and MCS (Medical Compression Systems) was sold to Zimmer Biomet in 2017.
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A test in development for early detection of cancers was able to pick up a dozen of the deadliest cancer types at stages I-IV with a high degree of accuracy while also determining where the tumor was located, according to validation data announced Monday.
Menlo Park, California-based Grail said an analysis from its Circulating Cell-Free Genome Atlas, or CCGA study, showed that its early detection test could pick up more than 20 total cancer types with a low false-positive rate. Data from the analysis will be presented at the American Society of Clinical Oncology Breakthrough conference, which takes place in Bangkok from Friday through Sunday.
“Today, cancer remains the second leading cause of death worldwide, and we believe an effective multi-cancer early detection technology has the potential to transform the cancer care landscape,” Grail CEO Hans Bishop said in a statement.
The data set included 927 participants from the CCGA, including 654 who had cancer and 273 who did not, as well as 337 participants without cancer from the STRIVE study. The data showed a high degree of specificity, 99.3 percent, meaning there was a low false-positive rate. When looking at 12 deadly cancer types – anal, bladder, colorectal, esophageal, head and neck, liver/bile duct, lung, lymphoma, ovarian, pancreatic, plasma cell neoplasm and gastric – the detection rate was 76 percent, with a 99.3 percent specificity. Detection rates between stages I and IV were 39-92 percent. For those cancers, the tissue of origin – which helps to accurately identify where in the body a cancer originates – was provided for 97 percent and correctly identified in 93 percent of cases.
Among the more than 20 cancer types, the detection rate was 55 percent, ranging from 18-93 percent depending on stage and with the tissue of origin correctly identified in 93 percent of cases.
Minimizing false positive rates is a crucial aspect of the kind of early cancer detection system Grail is developing, with even seemingly small false positive rates making a significant difference for patients. When it reported data on 2,508 participants in its study at the ASCO annual meeting in June, Grail reported a 99 percent sensitivity rate – corresponding with a 1 percent false positive rate that the company had forecast was likely to go down.
While a false positive rate of 1 percent in a 5,000-patient population is manageable, an interviewed expert at ASCO said, it could become more problematic when the population reaches hundreds of thousands or millions. The danger of a high rate is that it could create problems for the cost effectiveness of early detection, as patients who got false positive results would have to be subjected to several tests afterward.TrendMD v2.4.3
Arizona Medicaid Director Jami Snyder heard many complaints about enrollees missing medical appointments because the transportation provided by the state didn’t show or came too late.
So this summer she hatched a solution familiar to millions of Americans looking for an efficient ride: She turned to Uber and Lyft.
Arizona became the first state to revamp its Medicaid regulations to make it easier for ride-sharing companies to participate in its nonemergency transportation benefit. Under the changes, Arizona eliminated several safety rules, such as requiring all drivers to undergo drug testing and first aid training.
The strategy has added thousands of vehicles to the fleet serving Arizonans on Medicaid, nearly 24% of the state’s 7 million residents.
“It seemed like an obvious solution,” Snyder said. “So far, our anecdotal reports have been very positive.”
As they seek to lower costs and improve care, Medicaid and other insurers have begun to examine the transportation needs of patients — along with other so-called social determinants of health such as adequate food and housing. Whether states save money remains to be seen.
In 2017, more than 2 million Medicaid enrollees under age 65 ― about 4% of the program’s members — delayed care because they lacked transportation, according to a federal survey.
Lyft is working with about 35 state Medicaid programs or Medicaid managed care organizations, according to LogistiCare, one of the nation’s largest Medicaid transportation brokers. Uber works with Medicaid only in Arizona.
Lawmakers in Florida and Texas this year also relaxed state regulations to make it easier for Uber and Lyft to provide services for appropriate Medicaid patients. That service is expected to begin early next year.
Uber and Lyft can’t handle all Medicaid transportation demands because they generally don’t have enough drivers with cars fit to ferry people with serious disabilities, such as those who use a wheelchair. But Arizona’s Snyder said many Medicaid enrollees are healthy enough to use a typical ride-sharing service.
Van Means, executive director of a company that Arizona pays to arrange transportation for Medicaid enrollees, said the expanded options help even some patients who can’t use them.
“It gives us way more supply, it’s faster and frees up space [in specialized transportation] for people who need more substantial help such as those in wheelchairs,” he said.
In most traditional Medicaid transportation programs, patients need to reserve rides days ahead and then often must share a van. In contrast, the ride-sharing companies need little advance notice and can easily take solo passengers.
To ease the use of Uber and Lyft, states generally waive safety requirements that are standard for more traditional transportation. Those include mandates that drivers undergo drug testing and learn first aid and CPR. State officials said such mandates are not necessary since Uber and Lyft serve ambulatory enrollees who likely are in better health than those needing specialized transportation.
The ride-sharing companies already work with hospitals and health systems across the country, but participating in Medicaid could bring them millions of more riders.
Unlike typical Uber or Lyft riders, Medicaid enrollees don’t order rides on their smartphones. Instead, these patients will continue to request transportation services by phone or computer through their health plan or a Medicaid transportation broker.
The Medical Transportation Brokerage of Arizona said about 15% of rides taken by Medicaid recipients this summer relied on Uber and Lyft.
So far, though, Means said the brokerage hasn’t found the service substantially cheaper in most areas of the state.
Arizona officials did not have an estimate of cost savings.
Officials at Atlanta-based LogistiCare said working with Lyft in dozens of cities has added vehicles and helped speed service.
“The ride-sharing companies are cost-effective and for curb-to-curb, urban or suburban short-distance trips,” said Effie Carlson, a LogistiCare executive vice president.
But she cautioned that the companies are not the ideal option for enrollees who need extra time getting in and out of their house because drivers typically leave within five minutes of arriving.
Uber and Lyft are often cheaper than using taxis or other private transportation companies, but not always. She noted that when companies raise prices during peak-traffic hours, alternatives may be less expensive.
Carlson said her company decides whether ride-sharing services or more traditional transportation is most appropriate based on the health information provided about each Medicaid enrollee.
The Medicaid transportation benefit varies by state but typically includes rides by taxi services, wheelchair vans, private vehicles, and public transportation. Enrollees are eligible for the services if they do not have another means of transport.
Despite states’ growing interest in expanding transportation options, a University of Pennsylvania study, published last year in JAMA Internal Medicine, found providing ride-sharing services did not improve the no-show rate for primary care appointments among Medicaid patients in West Philadelphia. The no-show rate among patients offered free rides was 36.5%, compared with 36.7% for those who weren’t offered free rides.
Krisda Chaiyachati, co-author of the study and a University of Pennsylvania associate professor of medicine, said reliability of transportation is not the only factor determining whether Medicaid enrollees show for medical appointments. “People on Medicaid tend to live more chaotic lives, so they may be more OK with missing primary care appointments,” he said, referring to how low-income people often fear missing work, or have difficulties arranging childcare and other necessities.
Still, Chaiyachati envisions Uber and Lyft playing larger roles for Medicaid.
“Their cars can be everywhere, and having a dispatcher draw upon that network is a no-brainer,” he said. “It may not solve the transportation needs for everybody, but it’s certainly an answer for many.”
Megan Callahan, vice president of health care at Lyft, said she expects more states to adopt ride-sharing.
“I think what we are seeing is the beginning of a domino effect,” she said. “Our overall driver availability and speed are the big advantages that will have an impact on Medicaid members’ satisfaction.”
Uber officials said in about dozen cities they are developing a fleet of drivers trained to work with patients who must travel with fold-up wheelchairs, walkers and scooters.
“From a cost standpoint, we can save states significant dollars,” said Dan Trigub, head of Uber Health.
– The FBI released an alert this week about an increase in ransomware attacks across all sectors, including healthcare, state and local governments, and other infrastructure targets.
Over the last few months, the healthcare sector has seen two separate providers permanently close and others forced into downtime after falling victim to ransomware. A McAfee report recently showed ransomware attacks have doubled in 2019.
According to two recent reports from Emsisoft and the Institute for Critical Infrastructure technology, 491 providers have fallen victim to ransomware so far this year and hackers are ramping up ‘disruptionware’ campaigns for a greater impact on its victims.
“Ransomware attacks are becoming more targeted, sophisticated, and costly, even as the overall frequency of attacks remains consistent,” FBI officials wrote. “Since early 2018, the incidence of broad, indiscriminant ransomware campaigns has sharply declined, but the losses from ransomware attacks have increased significantly, according to complaints received by IC3 and FBI case information.”
Hackers have been leveraging phishing campaigns, remote desktop protocol vulnerabilities, and software vulnerabilities to infect organizations.
The phishing campaigns are typically generic, broad-based spam attempts, but FBI officials said that the recent ransomware attempts are much more targeted. Hackers may also compromise a victim’s email account first with precursor malware, which allows the infection to spread to other connected devices.
The FBI noted that brute-force attacks on the remote desktop protocol using trial-and-error user credentials, as well as those purchased on the dark web. And once access is gained, hackers deploy a wide range of malware variants, including ransomware.
Lastly, hackers are taking advantage of software vulnerabilities to deploy the virus. The FBI explained that a hacker recently exploited two remote management vulnerabilities used by managed service providers to launch ransomware attacks on three of the MSP’s customers.
The FBI also stressed that victims should not pay the ransom, “in part because it does not guarantee an organization will regain access to its data.”
“In some cases, victims who paid a ransom were never provided with decryption keys,” FBI officials explained. “Due to flaws in the encryption algorithms of certain malware variants, victims may not be able to recover some or all of their data even with a valid decryption key.”
“Paying ransoms emboldens criminals to target other organizations and provides an alluring and lucrative enterprise to other criminals,” they added. “However, the FBI understands that when businesses are faced with an inability to function, executives will evaluate all options to protect their shareholders, employees, and customers.”
To the FBI, whether an organization has decided to pay the ransom or not, the ransomware incident should be reported to law enforcement to provide the agencies with information that can be used to track down hackers and hold them accountable.
In order to prevent these attacks, the FBI stressed that the time for organizations to implement backups and other defenses is before, not after an attack.
“Having a recent backup to restore from could prevent a ransomware attack from crippling your organization,” FBI officials explained. “As ransomware techniques and malware continue to evolve and become more sophisticated, even the most robust prevention controls are no guarantee against exploitation.”
“This makes contingency and remediation planning crucial to business recovery and continuity,” they added. “Those plans should be tested regularly to ensure the integrity of sensitive data in the event of a compromise.”
Organizations should regularly backup and verify the integrity of the data, while ensuring they are not connected to the computers and networks they are backing up – such as physically storing them offline. Awareness and training should be a key focus, as end users are prime targets.
The FBI also suggested other less-common techniques, including disabling macro scripts from Office files sent by email. Organizations can also consider using Office Viewer software to open Microsoft Office files sent through email, instead of the full Office application.
“Implement software restriction policies or other controls to prevent the execution of programs in common ransomware locations, such as temporary folders supporting popular internet browsers, and compression/decompression programs, including those located in the AppData/LocalAppData folder,” FBI officials wrote.
“Employ best practices for use of RDP, including auditing your network for systems using RDP, closing unused RDP ports, applying two-factor authentication wherever possible, and logging RDP login attempts,” they added.
Application whitelisting should be implemented, as well as virtualized environments to execute operating system environments or specific programs. Organizations should also categorize data based on importance, while implementing physical and logical data network segmentation.
“For example, sensitive research or business data should not reside on the same server and network segment as an organization’s email environment,” FBI officials explained.
The Department of Homeland Security has also released two similar advisories in the last few months regarding the sudden increase in attacks. On average, ransomware causes nearly 10 days of downtime, and organizations can lose about 8 percent of data, according to a recent Coveware analysis.
A large Swiss drugmaker and a technology giant will work together to use data and artificial intelligence to speed drug discovery and development.
Basel, Switzerland-based Novartis and Redmond, Washington-based Microsoft said Tuesday that the alliance between the two companies would enable employees at Novartis to find insights in large amounts of data. It would also allow data scientists from Microsoft Research and Novartis’ own research teams to use AI to find new approaches to personalized medicine for macular degeneration, manufacture of cell and gene therapies and shorten the time to design new drugs. The companies are referring to the two objectives as AI Empowerment and AI Exploration.
“As Novartis continues evolving into a focused medicines company powered by advanced therapy platforms and data science, alliances like this will help us deliver on our purpose to reimagine medicine to improve and extend patients’ lives,” Novartis CEO Vas Narasimhan said in a statement. “”Pairing our deep knowledge of human biology and medicine with Microsoft’s leading expertise in AI could transform the way we discover and develop medicines for the world.”
Novartis has an existing partnership with chipmaker Intel that also involves using AI for drug discovery.
The pairing of the two fields has also been on the minds of some attendees at the ongoing CB Insights Future of Health conference in New York. One attendee, Atomwise CEO Abraham Heifets, addressed the skepticism that some people have regarding the application of AI to drug discovery and highlighted the importance of using it to make significant advances rather than small variations on existing science that end up feeding that skepticism.
“Computational chemistry has a long history of over-promising and under-delivering,” Heifets said in the interview. “What you really want is real discoveries where nobody knew what the answer was.”
Based in San Francisco, Atomwise has partnered with several companies – including the contract research organization Charles River Laboratories and Chinese drugmaker Hansoh Pharma – to use AI in drug discovery.
Another challenge to AI in drug discovery and development is cleanliness of data. Even something as simple as a typo can mean the difference between a molecule having a binding affinity of 8.241 nanomolars and 8.241 millimolars, due to the proximity of “n” and “m” on a keyboard, Heifets said. Indeed, when he looked at PubChem, the National Institutes of Health’s public database of chemical molecules and their activities against biological assays, he found that 98 percent of 240 million data points did not pass Atomwise’s quality control.
“I’m deeply skeptical of people who say, throw it in a neural network and let it figure everything out,” he said.TrendMD v2.4.3