Edition 14 — October 6, 2021
Good morning. 

In our last edition, we discussed the rapidly growing femtech ecosystem. A recent report from Rock Health underlines the acceleration: U.S.-based women+ digital health startups have already raised $1.3 billion in 2021, nearly doubling last year's total of $774 million. Yet, funding only accounts for 7% of U.S. digital health deals. Things are evolving, but there is still so much room to grow! We will keep you informed of further developments.

In addition, we've had our eyes on the staggering increase in news articles mentioning the digital transformation of healthcare companies during the pandemic, talked to Chenchao Liu from Silreal, and taken a deep dive into the following topics:
  • Smart toilet innovators believe the device we spend about 240 days of our lives on could become the ultimate health monitoring tool.
  • Health innovation breakthroughs around kidney disease have been sought in vain over the past 50 years. KidneyX wants to change that.
  • MIT's new Bionics Center aims to accelerate our journey to a future filled with bionics that help people overcome the challenges of disability.
We look forward to your feedback, and to seeing how these topics evolve in the future. 

And now, on to our MedTech roundup.

Smart toilets as health sensors of the future? 

Illustration by Mary Delaney

There are a few pictures of the future that we can't get rid of, no matter how old they are. Think of flying cars or intelligent refrigerators. Every few years, they are pulled out of the idea drawer and serve as a demo for a new generation of technologies. It is now time to ask ourselves, does this also apply to smart toilets?

The Guardian featured an in-depth article on the latest generation of smart toilets and their potential relevance in the healthcare industry. Smart toilet developers are convinced that we are virtually flushing away supposedly valuable data. That's because urine and feces are data-rich and readily available samples that have been underutilized, according to the U.S.-based Duke Smart Toilet Lab.

If this taboo subject could be made socially acceptable, researchers say toilets could make a career as alternative sampling devices. According to gastroenterology experts at Digestive Disease Week 2021, they could also take the form of smart home retrofit devices. Data collection would integrate seamlessly and unobtrusively into everyday life, and the analysis could help detect acute or chronic gastrointestinal diseases early.

And further: Scientists believe defecation also contains information about cancer and other diseases, and that it can reveal whether you've been exercising, what pills you're taking, how well you've been sleeping, and how high your calorie intake has been. Many diseases can be detected in the composition of the intestinal flora. This means a smart toilet could also give advice on diet and well-being, which would harmonize well with the increased interest in intestinal health—our German readers are probably familiar with Darm mit Charm by Giulia Enders, and our British readers might know You Are What You Eat by Gillian McKeith

→ Is a smart toilet a legacy future or really the future? Well. Let’s frame it this way: Sensor-based smart home systems and image recognition application costs have dropped significantly in recent years. Intelligent toilet innovations are therefore inevitable. If the basic components of your product are affordable, so are the experiments. It's interesting to see that scientists at Stanford are embracing the topic as much as traditional companies and startups. Even the Office of Technology Assessment at the German Bundestag (TAB) covered smart toilets recently in a short profile. It is clear that the topic will have to deal with discussions about data sovereignty just like any other IoT device. When you start measuring body-related data, you cross the privacy line—and few things are more personal than the result of going to the bathroom. So it's good to see that the topic is not just subject to hype.

→ In addition, we should pay more attention to the fact that almost half of the world's population does not have access to sanitary facilities or a toilet. That’s the more crucial problem to be solved. But there is a dormant opportunity in the automated analysis of fecal matter. The application could be particularly relevant for nursing and retirement homes; also, you don't have to get used to it in everyday life due to a pipe installation. 

→ Needless to say, whether smart toilets actually have health benefits must be clarified in further studies. But for us, it seems obvious that there are clearly outlined use cases. Yes, smart toilets are unlikely to radically transform our daily lives in the next 20 years, but much like flying cars and smart refrigerators, they will have a big impact in specific small-scale healthcare use cases. And that justifies any research on the subject. Smart toilets are here to stay.

Artificial kidneys could save millions of lives someday

Image: The Kidney Project, UCSF & VUMC 

KidneyX recently announced the winners of the $3.9 million Phase 1 of the KidneyX Artificial Kidney Prize. KidneyX is a public-private innovation accelerator program created in 2020 by the U.S. Department of Health and Human Services and the American Society of Nephrology. It seeks to improve the lives of people with kidney diseases by accelerating the development of drugs, devices, biologics, and other therapies across the spectrum of kidney care.

The Artificial Kidney Prize called for component or integrated prototype solutions that enable and improve the functionality, efficacy, and reliability of artificial kidneys. The winning entries were a genetically-engineered pig kidney xenotransplantation; a smart module for implantable, wearable, or bed-side artificial kidneys; a treatment for kidney failure; an implantable bioartificial kidney for continuous renal replacement therapy; an artificial kidney to improve vitality; and a dialysate-free waterless portable and implantable artificial kidney

→ Kidney disease is not uncommon. More than 850 million people worldwide live with minor or major kidney problems. But unfortunately, current treatment methods have not significantly changed for more than 60 years. That’s why breakthroughs in research are imperative. The development of a universal donor organ that would allow anyone to receive the benefits of a functioning kidney (including the benefits of additional sensors that could monitor the patient's overall health) would be such a breakthrough. However, basic work is still needed. And even as research makes progress, it remains consistently underfunded. Therefore, prizes like those offered by KidneyX are essential. Not only for monetary reasons, but also from a marketing perspective. 

New MIT institute to launch mobile clinic for 3D-printed prosthetics in Africa

Image: David Moinina Sengeh, MIT 2012

A new MIT research center is looking at merging the human body with advanced technologies such as robotic exoskeletons and brain-computer interfaces. The K. Lisa Yang Center for Bionics is funded by a $24 million donation from philanthropist Lisa Yang to MIT's McGovern Institute for Brain Research. The center is led by MIT Media Lab Professor Hugh Herr, who has earned a reputation as a pioneer in the field of robotic prosthetics and Ed Boyden, a professor of biological engineering, and of brain and cognitive sciences. 

According to the announcement, the faculty will prioritize three bionic technologies during the first four years: (1) The development of a digital nervous system to address movement disorders caused by spinal cord injury, (2) The exploration of brain-controlled limb exoskeletons to support weak muscles and enable natural movement for people affected by stroke or musculoskeletal disorders, and (3) The reconstruction of bionic limbs to restore natural, brain-controlled movements, as well as the sense of touch in bionic limbs.

→ But what we find particularly exciting is the fourth priority of the center: (4) The development of a mobile delivery system to provide access to prosthetics for patients in medically underserved communities. The announcement states that the MIT researchers will test a mobile clinic to deliver 3D-printed prosthetics in rural Sierra Leone. According to estimates, roughly 27,000 Sierra Leoneans were disabled or had one or more of their limbs amputated during the Sierra Leone Civil War. Today, less than 10% of the population benefits from functional prostheses. A mobile system could scale up production and access. The project has significant support from Sierra Leone President Julius Maada Bio and his Chief Innovation Officer David Moinina Sengeh, an MIT Media Lab graduate who worked on new prosthetics for amputees during his time at MIT. Be sure to read his personal summary of a lifetime's work.

The Covid-19 pandemic exposed weaknesses and accelerated the need for digital innovation across industries. The healthcare industry was no exception. 

In fact, healthcare turned out to be one of the most exposed industries of all—think of the lack of telemedicine and digital patient records (especially in Germany) during times of nationwide lockdowns, and the rapidly growing need for remote doctor consultations.

Without question, the pandemic proved that the time for more digital innovation in the broader MedTech scene is now! 

And the pressures on healthcare executives to deliver on this front are growing by the day.

According to data from CB Insights, mentions of both “digital transformation” in mainstream news outlets and “patient experience” in healthcare companies’ earnings calls skyrocketed during the pandemic and continue on the same trajectory post-pandemic.

Chenchao Liu, born in China and living in Germany since 2002, is the CEO of SILREAL GmbH. He holds a degree in chemistry from the Technical University of Munich and was a visiting researcher at the Max Planck Institute and ETH Zurich. He has profound consulting experience with a focus on European and Chinese healthcare systems. His expertise on China and healthcare is recognized by private companies and public institutions such as the German Federal Ministry of Health, the European Federation of Pharmaceutical Associations (EFPIA), and the Federation of German Industries (BDI).

Chenchao is also hosting the Sino-European Health Summit, which is taking place this week in Berlin. Make sure to check out the agenda and take part in the virtual sessions. 

Don’t rush for media coverage. Add value for patients and improve the state of healthcare.

 Chenchao Liu (CEO, Silreal)

Series B
Sync.MDdeveloper of a personal health record software designed to put patients in control of their medical records, raised $10 million in a Series B venture funding round from undisclosed investors.
PRWEB (2021-10-03) ↗
Series C
Brain health
NovaSignal, a medical technology and data company specializing in the assessment and management of brain health, closed $37 million in a Series C1 round. The funding round was led by Alpha Edison and Reimagined Ventures.
PEWIRE (2021-09-29) ↗
Membersy, an Austin, TX-based digital health company offering a subscription management platform designed for dental services, raised $66 million from Spectrum Equity.
FINSMES (2021-09-29) ↗
Early stage
Sanomea developer of a diagnostics innovation engine that combines biomarkers for medical-grade, at-home diagnostic products, received £2 million in an Early Stage round. The round was led by Heal Capital. 
SANOME (2021-09-28) ↗
Series C
Lab automation
OpenTrons, a Brooklyn, NY-based startup, raised $209 million through a combined Series C round. 
The round was led by SoftBank, with participation from Khosla Ventures and others. Opentrons develops open-source lab automation robots to help life scientists automate many of their experiments and processes.
FINMES (2012-09-24) ↗
Series E
Elligo Health Research, developer of a clinical research platform that uses electronic health records to find patients for trials and provide physicians with the staff, procedures, technology, and infrastructure needed to conduct the study, has raised $135 million in a Series E round led by Morgan Stanley Expansion Capital and Ally Bridge Group.
MEDCITYNEWS (2021-09-24) ↗

A few weeks ago, an article titled “How a 'fatally, tragically flawed' paradigm has derailed the science of obesity” caused quite a stir in the community. 

The main message of the article is that all obesity research is based on the false dogma that obesity is the result of too many calories and too little calorie breakdown. According to the authors, this school of thought led research into a dead-end for years because no one contradicted the prevailing paradigm. The paper argues that obesity is not an energy balance disorder, but a dysregulation of fat storage and metabolism. We don't get fat because we eat too many calories, but because the carbohydrates in our diet create a hormonal environment that favors the accumulation of excess fat. 

Whether the authors are right or not, science will show in the next few years. The first critical voices criticizing the criticism can already be heard. But what I found much more exciting was the authors’ rather blunt observation that we tend to forget to question existing thought patterns behind our paradigms. Yet this is a fundamental task of science and innovation: We all know that we cannot create anything new if we cannot think beyond fixed premises. And without the new, there is no progress. However, we tend to persist in our paradigms because they give us security and stability. It is only human to defend this stability. But in order to make progress, it is part of our duty to consistently challenge stable existing paradigms. This includes accepting contradictions and discussing them, as well as actively seeking contrary evidence. 

We have to leave the comfort zone of our chosen paths to find promising new ones—as difficult as this may be for us, especially when it comes to corporate innovation, where we are far too happy to rest on past successes. I speak from my own experience when I write that new opinions are always suspicious, especially if they do not fit into the bigger picture. But if they are presented in a professionally sound manner, we should deal with them. Even if that may hurt.