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The digital startup that missed the GLP-1 moment

March 21, 2024
Health Tech Correspondent

Good morning health tech readers! Today, I'm headed into Manhattan for the STAT Breakthrough Summit East. Be sure to follow along on our social channels and on our website for coverage of the event. If you're there, say hi!

Reach me: mario.aguilar@statnews.com

Big Tech

AI takes center stage for Google Health

As Google aims to talk as much as possible about its progress on artificial intelligence in the face of stiff competition for the AI spotlight, it's become a focus of the company's health care efforts. So Google's annual health-focused Check Up event earlier this week was an hour-long showcase of its work on health AI. It wasn't until the very end of the event that presenters brought up health care efforts in search and YouTube, two of the broader company's most important products.

Of particular interest was Google's approach to developing an experimental generative AI product that can have appropriate medical conversations with patients. The company recently put out a pre-print in which a research-only bot, called AMIE, talked to actors playing patients following a standard interview technique in an effort to come to a diagnosis. At the Check Up, Google announced its would begin testing AMIE in the real-world with an unnamed health organization. But now it would only conduct early parts of clinical interviews under the supervision of doctors without producing diagnosis.

Google Health AI leader Greg Corrado told me that he didn't believe going after diagnosis as a final goal was the appropriate way to investigate the potential of generative AI. Instead, the company hopes to explore how the technology can employ diagnostic reasoning in service of assisting clinicians.

The cautious posture here was characteristic of all of Google's AI announcements where it emphasized that it hopes to develop AI  for health care in ways that are safe, equitable, and responsible. It's also reflective of the constant insistence among AI developers that their products are intended to be used with "a human in the loop."

Also of note: The company's partnership with Apollo Radiology International to use AI to combat tuberculosis in India and a new open access data set of 10,000 images of dermatological conditions, developed in collaboration with Stanford Medicine.


Medical Devices

Why wearables aren't common in care yet

Screen Shot 2024-03-21 at 6.14.55 AM

For years, tech and medical device companies have been promising that wearable devices that measure activity, sleep, heart rate and more will contribute to a world with more personalized medicine, but this possibility for the most part remains unrealized. In a new paper for the New England Journal of Medicine, Stephen Friend (formerly of Apple and Merck), Geoffrey  Ginsburg (from NIH's All of Us initiative), and Rosalind  Picard (MIT) explore some of the many obstacles that must be overcome for the tech to take hold as more than just experiments. In general, these can be grouped into challenges with the health care systems and with patients.

The problems with the health care system may be more evident. There simply aren't well-developed universal pathways for getting data from devices in front of doctors, nor are there established workflows whereby doctors look at the data. Reimbursement schemes for devices and the medical labor required to support them are nascent.

Even if those problems are solved, the devices will not be useful if patients do not embrace them. The authors say that there ought to be efforts to educate patients from all backgrounds and and skill levels on how to use technologies so that they are more readily adopted. And the authors argue that patients ought to be empowered with control and access over the data being collected from devices and an understanding for how they might use it themselves, for example to change lifestyle behaviors.



Digital therapeutics

Did Better just miss the GLP-1 moment?

By now, you may have heard that last week prescription digital therapeutics company Better Therapeutics shut down and put itself up for sale. The company, which went public in 2021, last year received Food and Drug Administration clearance for AspyreRx, its app that encourages behavior change in people with type 2 diabetes and had been shown to reduce their HbA1c levels. It does leave me wondering if of all the struggling PDT companies out there Better didn't just barely miss its window for success.

First the obvious: The shutdown wasn't a surprise. Despite eking out its regulatory clearance last year the company had been running out of money for a long time and had already undertaken some desperate cost-cutting measures. Like other defunct developers of prescription app treatments, Better realized probably too late that adoption by doctors and insurers would take a lot longer than they initially thought. The company's last hope was that some interested medical device or pharmaceutical company would swoop in and make a strategic bet on them.

But the company's demise comes just as GLP-1 medications are revolutionizing  diabetes and weight loss treatment and opening up new opportunities for digital companies that can  support aspects of care around the drugs. Diet and exercise changes, which are part of Better's program, are indicated on drug labels. Digital companies are hoping to sell employers and health plans on who must pay for drugs on programs built around GLP-1s, and Better had already put out some data suggesting potential benefits to people on the drugs. Though the company hadn't yet developed a product for the weight loss indication driving everyone mad, that opportunity seemed on the horizon.

Despite the business model challenges around PDTs, I'd been told by a few sources that Better's data showed promise. Maybe its assets can now be had for cheap by someone with the money to realize their potential with GLP-1s.


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What we're reading

  • Apple keeps losing patent cases. Its solution: rewrite the rules, New York Times
  • PocketHealth lands $33M to build out its medical image exchange platform, Fierce Healthcare
  • U.K. health officials and researchers try to carve a path for more individualized genetic treatments, STAT
  • Can we learn from an imagined ransomware attack on a hospital at home platform?, NPJ Digital Medicine

Thanks for reading! More on Tuesday - Mario

Mario Aguilar covers how technology is transforming health care. He is based in New York.


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