Digital biomarkers are healthcare’s next frontier

Blood pressure, body temperature, hemoglobin A1c levels and other biomarkers have been used for decades to track disease. While this information is essential for chronic condition management, these and many other physiological measurements are typically captured only periodically, making it difficult to reliably detect early meaningful changes.

Moreover, biomarkers extracted from blood require uncomfortable blood draws, can be expensive to analyze, and again, are not always timely.

Historically, continuous tracking of an individual’s vital signs meant they had to be in a hospital. But that’s not true anymore. Digital biomarkers, collected from wearable sensors or through a device, offer healthcare providers an abundance of traditional and new data to precisely monitor and even predict a patient’s disease trajectory.

With cloud-based servers and sophisticated, yet inexpensive, sensors both on the body and off, patients can be monitored at home more effectively than in a hospital, especially when the sensor data is analyzed with artificial intelligence (AI) and machine-learning technology.

Opportunities for digital biomarkers

A major opportunity for digital biomarkers is in addressing neurodegenerative diseases such as mild cognitive impairment, Alzheimer’s disease and Parkinson’s disease.

Neurodegenerative disease is a major target for digital biomarker development due to a lack of easily accessible indicators that can help providers diagnose and manage these conditions. A definitive diagnosis for Alzheimer’s disease today, for example, generally requires positron emission tomography (PET), magnetic resonance imaging (MRI) or other imaging studies, which are often expensive and not always accurate or reliable.

Cost savings and other benefits

Digital biomarkers have the potential to unlock significant value for healthcare providers, companies and, most importantly, patients and families, by detecting and slowing the development of these diseases.

Isabl’s rapid whole-genome analysis opens the playbook for cancer treatment

Every cancer is unique because every person is unique, and one of the most important weapons in any cancer battle is information. Isabl offers that in abundance through rapid sequencing of cancer cells’ entire genomes, potentially showing which therapies will and won’t be effective within days. The company has received a breakthrough designation from the FDA and raised $3 million to bring its approach to market.

The last ten years have brought numerous medical advances due to the commoditization of genomic processes from sequencing to analysis, and cancer treatment is no exception. In fact, because cancer is (though it is a simplification) genetic mutation that has gotten out of hand, understanding those genes is an especially promising line of research.

Panel tests look within the DNA of cancerous cells for mutations in a selection of several hundred genes known to affect prognosis and clinical strategy. For instance, a cancer may have certain mutations that render it susceptible to radiation treatment but resistant to chemo, or vice versa — it’s incredibly helpful to know which.

Isabl co-founder and CEO Elli Papaemmanuil explains that however helpful panel tests are, they’re only the beginning.

“These tests have been designed very carefully to look for the most common mutations, and they have revolutionized cancer diagnosis for patients with common cancers,” she said. “But patients with rare cancers — and what we define as a rare cancer is still a third of patients — don’t benefit from them.”

Even many with common cancers may find that their condition does not involve mutations of these most predictive genes. The relevant genes are somewhere among the other two billion base pairs — current tests only look at about 1 percent of the genome.

While the technology exists to look at that other 99 percent, it has historically been expensive and slow compared with panels, and analysis of the resulting large body of data was likewise difficult and time-consuming. But Isabl’s tests show that it’s definitely worthwhile.

Diagram showing information (groups, individuals, cells) going into an analysis.

Image Credits: Isabl

“It turns out that whole-genome sequencing can detect many more clinically relevant findings — results we can act on today. And what we’ve done is develop a platform that lets us summarize it in a way that doctors can read and use, in a day,” Papaemmanuil said. They call it a “clinically actionable whole genome and transcriptome test,” or cWGTS.

The company was formed out of research Papaemmanuil did at Memorial Sloan Kettering, a cancer care and science nexus in New York. “You could see all these successes from panel testing, then all these patients who weren’t benefiting. But in my lab we had the tech and the know-how,” she recalled. They collected and combined three different datasets: the germline (i.e. patient’s) genomes; the tumor’s genome, and also its transcriptome, essentially what the body produces from transcribing the DNA.

“This gives a really full picture of the profile of the tumor,” she said. “Rather than having a classifier or a model that annotates the mutations [i.e. an automated panel test], we have analytics that integrate those three layers to interpret the role of the mutation and its relevance to each tumor type.”

Though it does own the whole process from sampling to report, Isabl’s key advance is data-based and therefore “there is no technical obstacle to making this solution available today. And we’ve demonstrated we can do it at scale,” Papaemmanuil said. But in the medical world, just because it’s possible doesn’t mean it’s permitted. The FDA has granted the technology with “breakthrough” status, which is a fast track — but even the fast track is slow in the federal government.

While full clinical approval is probably 3-5 years away, that’s much faster than the 5-10 years estimated by the industry for this type of application. But research, both for validation and other purposes, is ongoing, having just published the main paper proving out the process today in Nature Communications. (Though this study focuses on pediatric and young adults cancers, the technique is not limited to those demographics.)

“The seed round is very much to let us do the roadmap — it’s a good starting point for getting the necessary evidence and approvals,” Papaemmanuil said. “We’re already partnering with cancer centers to do studies, and most importantly, to hear from oncologists on what they need and how they’d like the data.”

From left, Isabl co-founders Andrew Kung, Elli Papaemmanuil, and Juan Santiago Medina.

The $3 million round was led by Two Sigma Ventures, with participation from Y Combinator, Box 1, and other firms. Papaemmanuil’s co-founders are CTO Juan Santiago Medina and Andrew Kung.

She also made it clear that Isabl’s research would be conducted openly — “We have a very strong scientific scientific foundation and will be active in publishing the work. The data needs to be both published and made accessible in a form that will enable further research,” she said. The self-reinforcing play of producing and identifying predictive data could prove an incredibly valuable resource across many disciplines.

Isabl is an example of the power of a more or less pure data play in an industry more frequently associated with advances in the lab — though of course it took a lot of lab work to produce in the first place. But when automation of key processes, in this case DNA transcription, enables a huge uptick in data capture, there’s always value to be found in it. In this case that value could save many lives.

Is there hope for digital health startups post-Roe?

Hello and welcome back to Equity, a podcast about the business of startups, where we unpack the numbers and nuance behind the headlines.

This is our Wednesday show, where we niche down to a single topic, think about a question and unpack the rest. This week, Natasha asked:  How do digital health startups build in a post-Roe world?

The question comes after Natasha’s recent Startups Weekly column, “When your startup’s core mission is set to be overturned.” The piece explores the ripple effects of the looming Roe v. Wade overturn, specifically in how it impacts startups. But, let’s not hypothesize. We brought on Kiki Freedman, the CEO and co-founder of Hey Jane, to answer our big questions about building, raising, and existing when so much regulatory scrutiny is weighing on your business. A direct-to-consumer health company that specializes in the delivery of abortion pills, Hey Jane about to kick off its fundraising process which makes for an interesting tension. The startup – especially today – really sits in the middle of two intense moments: an overturn to Roe v. Wade would threaten all of its work, and a toughening, risk-averse VC market could be a hurdle toward next financing.

Enjoy the show, and let us know if you like this interview format. Also, here’s the Found interview that we referenced during the show as well!

Equity drops every Monday at 7 a.m. PT and Wednesday and Friday at 6 a.m. PT, so subscribe to us on Apple Podcasts, OvercastSpotify and all the casts.

CarePoint raises $10M to spread healthcare tech across Africa

CarePoint, a technology-driven healthcare startup, has raised $10 million bridge round to accelerate its growth across Africa, as it seeks to make healthcare accessible to the masses.

The startup recently entered Egypt, its fourth market in Africa, after Kenya, Nigeria and Ghana. It is now eyeing North and East Africa, to continue its growth which is driven by mergers and acquisitions.

The startup’s founder and CEO, Dr. Sangu Delle, told TechCrunch that they are in the process of setting up telemedicine centers in their facilities and building “micro-tech-enabled-clinics” targeting the masses. This will grow CarePoint‘s, formerly known as Africa Health Holdings, portfolio beyond in-person visits.

“The micro-clinics will have, at most, 12 employees, including a nurse. The patients will consult with doctors virtually. We are taking this route because we realized that as much as the mobile subscription in Africa is great and growing, if you look at it from an internet penetration perspective, so many people are still locked out because they cannot afford mobile data,” said Delle.

“These clinics are a way of democratizing access, and taking quality healthcare closer to the people, while making it affordable to them too,” he said.

Patients are also able to access care virtually through CarePoint’s MyCareMobile app, which links them to diverse services through teleconferencing, including consultations with their doctors, test results and 24-hour emergency response.

The startup is backed by five brands, including Sahe in Egypt, Meridian Health Group in Kenya, Rabito Clinic in Ghana and Nigeria’s Care Point, and Lilys Hospitals, all operating a total of 65 facilities.

Delle founded CarePoint after a lengthy career as an investor and CEO at Golden Palm Investments, a venture firm with an interest in early-stage opportunities in Africa, where he still serves as the chairman.

“At Golden Palm we built a very active venture capital practice and invested in many of the leading tech startups today – including Flutterwave and mPharma. So, everything about CarePoint started at Golden Palm since it incubates businesses too,” said Delle, a World Economic Forum Young Global Leader, and a Harvard and Oxford graduate

“We first started looking at healthcare because we realized that for us to have any socio-economic transformation, we have to solve health care challenges too. And to contextualize it, we (Africa) have about 16% of the global population, 26% of the global disease burden, but only 3% of global health care workers and 1% of global healthcare resources. We need to urgently bridge the gap, or we’re going to be in real trouble,” he said.

Delle appealed for urgent action and investment in the healthcare sector, especially given that the continent’s population is expected to almost double in the next three decades.

“From our thesis and pilot, we believe we can use technology as a key competitive differentiator to democratize access, and improve the quality of care,” said Delle.

Delle said CarePoint will use part of the funding to build data science and AI teams to strengthen its technological resources, in addition to introducing new products.

The latest funding round was led by TRB Advisors, and brings the total funding raised by CarePoint to $30 million. It follows a $18 million series A round announced  mid-November last year.

New and existing investors that took part in the bridge round include Delle, Breyer Capital, Beyond Capital Ventures (BVC), M3, Inc, Asia Pacific Land/ Natural World Limited, and Alan Waxman, who is Sixth Street Partners’ CEO.

Eva Yazhari, a general partner at BVC, said, “CarePoint is at the forefront of creating solutions through its three core pillars of a scaled network of healthcare facilities, a strong technology backbone, and patient-centered care highlighted by the first Africa-focused healthcare data repository.”

The BVC also recently invested in Kasha Global, a Femtech retailer in East Africa and Viebeg, a heathtech company streamlining the medical supply chain in Eastern and Central Africa

“Beyond Capital Ventures is excited to participate in CarePoint’s Series B bridge round, and will work with Dr. Sangu Delle to scale an emerging technology-driven healthcare system in Africa… CarePoint is capturing demographic shifts to transform Africa into the next frontier for healthcare and transform health outcomes,” said Yazhari.

 

Google faces fresh class action-style suit in UK over DeepMind NHS patient data scandal

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Peloton is releasing a rowing machine

Peloton punctuated a rough week with a bright spot, teasing the next major addition to its home exercise offerings. In a blink-and-you’ll-miss-it moment, the connected fitness brand confirmed the forthcoming release of a home rowing machine. Beyond the quick glimpse and a “coming soon” graphic, that’s apparently all we’re getting for now.

From the quick shots, the rower is aesthetically right in line with the company’s existing bikes and treadmills. It appears to be an all-black sit-down machine with a standard resistance cable and a large display for watching Peloton’s fitness courses.

The system was briefly unveiled as part of its two-day “Member Event.” The company notes, “Peloton will be bringing its best-in-class fitness experience to the world of rowing! Combining cardio and strength — Peloton is excited to add this total body workout into its powerhouse arsenal of content.”

Image Credits: Peloton

The product has been rumored since last year, though it seems likely the company’s continued financial struggles derailed an earlier release. New CEO Barry McCarthy outlined the company’s existing inventory issues on a recent investor call, noting:

The balance sheet challenge has been managing inventory. We have too much for the current run rate of the business, and that inventory has consumed an enormous amount of cash, more than we expected, which has caused us to rethink our capital structure (more on this in a moment). Fortunately, the obsolescence risk is negligible, and we believe the inventory will sell eventually, so this is primarily a cash flow timing issue, not a structural issue.

Launching an entirely new product line is a risky move for a company struggling to move old stock. Of course, financial issues aside, the Peloton brand is still a strong one in this category, and the addition of a much requested piece of hardware could certainly drive adoption.

Rowing machines have become an increasingly popular third option for full-body workouts, after fitness bikes and treadmills. Companies like Hydrow and Ergatta have been pushing to fill a large segment of the home fitness enthusiast that Peloton has thus far left on the table.

Image Credits: Peloton

Along with the rower tease, Peloton also announced a raft of new features, including Invite Friends, which lets users schedule collaborative workouts within the app. Just Workout, meanwhile, makes it possible to track non-Peloton running, cycling and walking in the app, so users can add up their outdoor excursions. The company says Just Workout was “consistently a top requested feature.”

The company also announced plans to open its Peloton Studios in New York and London for member workouts.

‘Move fast and break things’ is a bad idea for health tech startups

It may seem counterintuitive, but one of the reasons some entrepreneurs are drawn to healthcare are the regulations. No industry outside of defense is as heavily scrutinized, and for good reason: When you deal with people additional caution is essential.

Rules, requirements and regulatory complexity may be barriers to entry in the world of digital health startups, but they also present opportunities.

Founders often find creative ways to reconcile the additional oversight, like saying that their launch is merely a proof of concept, or that they can’t justify the cost of spending hundreds of thousands of dollars a month on advertising to attract new users.

When venture funding was scarce, there was a compelling need to prioritize speed and maximize the runway provided by smaller seed rounds. The environment, however, has changed — burgeoning investor interest and ample available capital have meant that there’s an even greater need to allocate significant budget to compliance.

Speed and efficiency may be essential for startups, but regulatory compliance need not be a bottleneck or a financial drain.

If compliance isn’t a consideration from the start, founders will sooner or later end up in a situation where they have to scramble to fix things behind the scenes, spending huge amounts of money on legal fees — and that’s the best case scenario. In the worst case, a deal can blow up.

It is understandable how these concerns can be overlooked at the beginning. There’s a certain amount of creativity and dissatisfaction with the status quo necessary for founders to conceive of building something that doesn’t already exist.

But when you’re building a digital health company, the ultimate end user is a person in need of medical care. The stakes are higher than creating the next puzzle game or food delivery app.

Google and Samsung team up to make sharing data between health and fitness apps easier

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

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

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

Image Credits: Google

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

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

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

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Google’s Pixel Watch arrives this fall

Here’s something to wrap your brain around: Google has never made its own smartwatch. The company has played in and around the space at least since 2014, with announcement of Android Wear, but it’s never gone as far as making its own product. Given that the market has been as hot as it has for as long as it has, the news really boggles the mind.

All of that will change this fall, at the company’s annual hardware event. Alongside the recently teased Pixel 7, Google will finally — officially — debut the Pixel Watch. I say “finally” here, because 1. This thing has been leaking all over the place (including a very credible prototype lost at a bar in recent months) and 2. We are, at least, getting a decent peek at the product today.

Image Credits: Google

The latter is a tack that Google has also taken with the Pixel 7 and Pixel Tablet (which is even further from production) — it also offered an early look at the revamped Pixel 6 ahead of that product’s release. It bucks the standard industry trend of keeping things under as tight a lock as possible until the official release date, but it makes a lot of sense for a company hoping to dramatically swing its hardware fortunes.

The truth is that Google doesn’t have a great track record with consumer hardware. Last year’s Pixel 6 was an important step in that direction. This (well, fall) is the moment Google will finally cash in all its chips. That includes its $40 million January 2019 purchase of Fossil’s smartwatch technology and last year’s $2.1 billion Fitbit acquisition. Included in the wearable Katamari Damacy are Fossil’s Misfit purchase and Fitbit’s acquisition of both Pebble and Vector. Honestly, it’s stunning to take a moment to consider all of the time and money that went into getting us to this place.

Image Credits: Google

It’s not so much that the Pixel Watch is make or break for Google’s wearable fortunes, exactly, but there’s a lot riding on the product. It’s understandable that the company is doing its damnedest to keep the hype cycle going for the next several months — especially given the fact that its release timing will likely put the product right up against the Apple Watch Series 8 announcement.

The details are still fairly thin — as you’d expect for a product that’s not going to debut until the fall. We do, however, now know a handful of things about the upcoming smartwatch. For starters, the leaks appear to largely check out. From a design perspective, it’s more or less what we’ve been seeing in renders and lost devices. In contrast to Apple and Fitbit’s hardware designs, this thing is very round — something it may well have adopted from the Fossil acquisition. That appears to include a slight convex curve on the glass watch face.

Image Credits: Google

Like the Apple Watch, it features a physical crown, likely used to augment touchscreen navigation. The watch frame is made from recycled stainless steel, attaching to what appears to be custom bands. The device will — naturally — run the latest version of Wear OS, serving as the flagship product for the company’s beleaguered wearable operating system. It will be interesting to see what commonalities it shares with the Tizen hybrid Samsung’s been running on its latest Watch.

In its press material, the company writes, “The new Wear OS experience is designed to feel fluid and easy to navigate. It’s more glanceable than ever with refreshed UI and rich notifications, so you can stay present at home, at work, or on the go. And it delivers the apps you love, like your favorites from Google and others for download in Google Play, made for your wrist.”

Image Credits: Google

All we’ve seen as of this writing, however, are glimpses of what looks to be an extremely minimalist black and white interface. There’s a pop of color in the Assistant demo, which features the weather. The watch face, on the other hand, is straight-up black and white, featuring a number of elements pulled directly from Fitbit.

“It takes time to integrate a company with all the technology and people that Fitbit has,” Google hardware head, Rick Osterloh, says. “This is the first time you see it come to market. We’re really excited about the combination. I’ve personally been a Fitbit user for several years, so I’m thrilled to see this come together. I think it’s going to be a perfect combination.”

The company adds, “Get insights into your health with continuous heart rate and sleep tracking, see your Active Zone Minutes when you’re working out, and track your stats and progress against your personal fitness goals.”

Image Credits: Google

The Fitbit acquisition immediately catapults the product toward the head of the pack of health-focused consumer wearables. The company has made some great strides on that front in the hardware and software departments, including the recent announcement of an always-on A-Fib detection. It will be interesting to see if that makes it into the product at launch.

“[Fitbit CEO James Park] and his team are driving the development of this watch,” says Osterloh. “They bring a ton of expertise in this space and we bring a lot of exptertise with the smartwatch OS with Wear OS. That combination has been incredibly powerful. It helps add capability to Fitbit. It also allows Fitbit to build a very modern smartwatch.”

The executive added that Fitbit devices will continue to be developed under that brand, and that — as promised during the acquisition — health information will be siloed on the Fitbit side.

Image Credits: Google

Naturally, the device sports the standard Google suite of software, including things like Assistant, Maps and Wallet, which will be accessible without a smartphone, courtesy of an optional LTE connection. Naturally, the product will be designed to work better with the Pixel 7 set to be officially unveiled alongside it (including the use of features like Find My Device and smart home control). Interestingly — but perhaps not surprisingly — it won’t work with iOS devices.

I expect/hope Google’s still got some surprises up its sleeve here. It’s got a nice-looking piece of hardware and a wealth of resources from the Fitbit and Google software teams. But all of that and more are going to have to come together in an extremely compelling way to make a splash in the already mature smartwatch market. As for cost, Osterloh says the Pixel Watch will have “premium pricing,” which leads one to believe it will be more expensive than Fitbit’s $200 Versa. Hopefully it will fall somewhere between that and the latest $350 Galaxy Watch.

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Modern Fertility co-founder leaves Ro a year after acquisition

Modern Fertility co-founder Afton Vechery is leaving healthcare unicorn Ro about a year after her company, built alongside co-founder Carly Leahy, was sold for north of $225 million. According to an internal e-mail from Ro’s executive team, obtained by TechCrunch, Vechery is leaving her role as president of women’s health of Modern Fertility to pursue her next venture. Effective May 18, she will become an advisor to Ro’s fertility services.

“While this is bittersweet news, fertility and women’s health remain among our key growth opportunities and areas where we will continue to invest heavily,” the email, sent to Ro’s staff, continued. It noted that Ro general manager Hannah Ma will now be a general manager of fertility and women’s health.

Vechery sent an e-mail to staff as well, addressing that her departure “may be a surprise” to people at the company. In the note, obtained by TechCrunch, Vechery said “I am and always will be an entrepreneur at heart and this is how I can personally be the most effective in impacting global women’s health, a field in which I am deeply passionate.”

“Taking a moment to reflect, I remember when we started Modern Fertility, we did not know how the market and people would react,” she wrote in the e-mail. “How could we make something as complicated and taboo as fertility easy to understand and even something women actively wanted to understand? But we did it, and we not only struck a chord, we created an entirely new category that hadn’t existed before.” She added that “joining Ro was the best thing for Modern Fertility, and the path you have ahead is such an exciting one. You have an incredible amount of runway and resources to continue to empower women to own the decisions that impact their bodies and futures.”

Modern Fertility declined to provide a comment on the record. The co-founder’s departure so soon after acquisition isn’t unheard of, considering how integrations can cause former executives previously bitten by the entrepreneurship bug to try their next thing. However, in Ro’s case, the digital health company has lost a number of executives across different departments in recent months, most recently parting ways with Ro COO George Koveos and GM of Ro Pharmacy Steve Buck.

Vechery’s departure has been rumored for over six months — first sparked by an employee exodus that peaked last year. At that time, former and current employees said that Ro’s acquisition of Modern Fertility, a reproductive health company, felt like an acquisition “for optics” than for actual change, given the fact that Rory, Ro’s previous vertical for women’s healthcare, had been given little to no investment. Rory was led by entrepreneur Rachel Blank, but she too left Ro to start her own company in women’s hormonal health. The women’s health practice was eventually refreshed by the Modern Fertility acquisition — yet given this precedent, former and current employees worried that Modern Fertility would also face turnover.

In the same e-mail announcing Vechery’s departure, leadership said that they will put “more energy and resources toward fewer initiatives” for the remainder of Q2 and H2. “Narrowing the focus does not mean we will launch any fewer products or services for patients. In fact, we believe it will have the opposite effect. We will increase the speed of innovation for patients,” the memo continues, also noting that it will build “new products for existing patients.”

Like many richly valued startups navigating new markets, Ro’s somewhat mixed messages do have one clear statement: the startup is going through change. It is certainly growing its fertility focus, acquiring Dadi in November. Then, in February, the startup raised an inside round at a higher valuation — giving it a financial cushion for the coming months. Yet, as leadership notes in the internal e-mail, the “mantra for the remainder of the year (and potentially beyond) will be growth with discipline.” Quite a different feel than just last year when the company raced to be the “Amazon of healthcare.”

Current and former Ro employees can contact Natasha Mascarenhas by e-mail at natasha.m@techcrunch.com or on Signal, a secure encrypted messaging app, at 925 609 4188.