Ian Morrison died yesterday. 4 years ago in one of the early THCB Gang’s, we had a rash of late cancellations. So I talked to Ian solo about his journey, and his views about health care. I re-listened to it this morning and thought you might enjoy it
Ian Morrison
I got the very sad news today that Ian Morrison died peacefully at home yesterday. He had been sick and in hospice for some time but a few months back he told me that he was going for Jimmy Carter’s record. Ian was my first boss in American health care when I worked for him at Institute for the Future and he was as kind and lovely as he was funny and knowledgeable. I was very glad that when I started THCBGang during the pandemic that he was a regular member.
Ian spent decades working with everyone across health care in American and internationally, but as he used to say essentially was paid to insult people. That he did it so humorously and usefully was the reason he kept being invited back. Any Ian Morrison keynote at a big health care conference was both a chance to learn something and laugh hysterically.
He also never ignored the chance to help those trying to make health care fairer and more equitable, serving on the boards of Martin Luther King Jr hospital, the California Healthcare Foundation and many others. He remained a jovial Glaswegian socialist at heart.
Ian liked to say that he went from Scotland where death was imminent, to Canada where death was inevitable, to California where death was optional. Sadly that last crack wasn’t quite true.
My heart goes out to his wife Nora and their children and grandchildren. There’ll be a more formal obituary and a celebration of his life in the days and weeks to come–Matthew Holt
Jonathan Bush, Zus Health
It’s always fun to chat with Jonathan Bush. You kids today may not remember that he was the first CEO to take a cloud-based (Health 2.0!) company public back in 2007! Athenahealth didn’t end up challenging Epic because a cosmically evil hedge fund took it (and him) down as it was on its way to try to do that, but Jonathan has moved on and is now building a clinical data integration company called Zus Health. We talked Zus, digital health, whether there will ever be value-based care and more. 20 mins of digital health gold right here–Matthew Holt
Peter Yellowlees, AsyncHealth
Peter Yellowlees MD is CEO at AsyncHealth–this is a new company that is doing the intake interview for a psychiatrist or psychologist session. Peter demos how the AI agent asks questions, how a patient answers in real time. Then after submitting the answers, the AI creates both a full transcript in the back end, and then a summary which the clinician can use in advance of seeing the patient. You’ll see the real time transcript and patient summary. Very accurate and impressive. That saves a significant amount of time in the intake process and helps the patent get to the right type of treatment. It’s early days for Asynch Health, but you’ll quickly get the idea about how this use of AI might change one part of care–Matthew Holt
Aniq Rahman, Fabric Health
Aniq Rahman is the CEO of Fabric Health. In basically two years Fabric has changed its name (nee Florence) bought some health tech standouts in the fields of symptom checking and asynchronous care (Gyant, Zipnosis), a medical group (Team Health’s virtual care) and the telehealth part of Walmart (MeMD). In the 2010’s Aniq built an analytics company acquired by Oracle & turned to health care after seeing his father go through the system. What he is trying to build is a company that can help providers (and now others) go from soup to nuts in helping a consumer online. He explained how those pieces fit together to match the look and feel of the customers to support their staff but also to augment them with Fabric’s people where needed. Now, with the Walmart/MeMD acquisition they are adding employers (and payers and even life science companies). There’s a lot to be done here, and we had a great chat about where consumers are going to get their care, what else Fabric needs to do (Aniq is thinking provider directories next!), and what the secrets are about General Catalyst’s work at Summa Health (sadly not much inside info!!)–Matthew Holt
Maybe AI Doesn’t Read Blueprints
By KIM BELLARD
Gosh, who knew that Jan 13 would be an AI day, with at least three major announcements about “blueprints” for its development going forward? Of course, these days every day is an AI day; trying to take in all AI-related news can be overwhelming. But before some other AI news drowns them out, I wanted to at least outline today’s announcements.
The three I’m referring to are the Biden Administration’s Interim Final Rule on Artificial Intelligence Diffusion, OpenAI’s Economic Blueprint, and the UK’s AI-driven Plan for Change.
The Biden Administration’s rules aim to preserve America’s lead in AI, stating: “it is essential that we do not offshore this critical technology and that the world’s AI runs on American rails.” It establishes who advanced chips can be sold to and how they can be used in other countries, with no restrictions on 18 key allies and partners.
It also sets limits on model weights for AI models, seeking to constrain non-preferred entities’ ability to train advanced AI models.
“The U.S. leads the world in AI now, both AI development and AI chip design, and it’s critical that we keep it that way,” Commerce Secretary Gina Raimondo said in a briefing with reporters ahead of Monday’s announcement
Not everyone is happy.
Continue reading…Aneesh Chopra talks Cancer Navigation Challenge & more
Aneesh Chopra is the former CTO of the US under Obama. He’s now head of strategy at Arcadia, but this week is one of the driving forces behind the new challenge called “Transforming Cancer Navigation with Open Data & APIs” . I caught up with Aneesh about why the need for this type of data exchange and why caner, and also more generally about interoperability, data analysis (his day job) and the impact of AI. Aneesh is an optimist but also about the most articulate person in health care explaining what is going on the ground and in policy with the regulations and actions of data exchange, and its uses. Pay attention–Matthew Holt
Sleep: Watch This Space
By MIKE MAGEE
In case you’ve missed it, sleep is all the rage in neurosciences these days. They are fast at work rebranding it “the brain’s rinse cycle.” The brain, protectively encased in an unyielding bony casing, lacks the delicate lymphatic system that transports used body metabolites to breakdown and extraction sites in all other parts of the body.
But in 2012, neuroscientist Maiken Nedergaard, identified a unique network of delicate channels (“tiny passages alongside blood vessels”) inside the brain that collect and discharge brain metabolites and waste materials including amyloid. This system, or “ultimate brainwasher” as some labeled it, was formally titled the “glymphatic system.”
That same study also suggested that flow through the glymphatic system is enhanced during portions of the sleep cycle. Now 12 years after the original research, the same team, in a study in mice published in the Proceedings of the National Academy of Sciences USA journal, found that regular contractions or oscillations of tiny blood vessels in the brain, stimulated by adrenaline cousin, norepinephrine, generated the brain scrubbing liquid flow through the channel system. The focal contractions, normally occurring ever 50 seconds, speed up the pump to every 10 seconds, in sync with peaks of norepinephrine release during sleep.
Sleep deprivation appears to not only interrupt this cycle, and allow harmful wastes to accumulate, but also disrupts other mental health functions that scientists are just beginning to understand. For example, researchers in 2021 established that “sleep deprivation impairs people’s ability to suppress unwanted thoughts.” They were able to identify a special location on the brain cortex responsible for storing away memories, and suppressing and delaying their future retrieval. They further demonstrated enhanced activity at the site during REM sleep. As the lead investigator noted, “That’s interesting because many disorders associated with debilitating intrusive thoughts, such as depression and PTSD, are also associated with disturbances in REM.”
The new work may help explain destructive recycling of historic conflicts among and between Silicon Valley AI uber-competitors. They may not be getting enough sleep, recycling historic grudges and grievances.
As the sleep scientists reported in the December, 2024 publication, “The functional impairments arising from sleep deprivation are linked to a behavioral deficit in the ability to downregulate unwanted memories, and coincide with a deterioration of deliberate patterns of self-generated thought. We conclude that sleep deprivation gives rise to intrusive memories via the disruption of neural circuits governing mnemonic inhibitory control, which may rely on REM sleep.”
Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex. (Grove/2020)
Ain’t no shame in the heart of the VC
By MATTHEW HOLT
It’s JPM week. That means a ton of startup bros wandering around San Francisco wondering who all the biotech guys and investment banker greyhairs are and why they’re still wearing suits.
Unlikely to be wearing suits are the digital health kids and the VCs they are trying to hunt down. The glory days are long gone. Athenahealth and Venrock are no longer having competing parties (or parties at all) and most of the starving startup kids looking for free booze and food are trying to scrounge invites to law firms who are still charging $1500 an hour for associate time before their clients notice that ChatGPT will do the same for $20 a month.
But venture in digital health continues on, even if much of it is subtexting cramdown M&A, such as last week’s General Catalyst deal funding Transcarent’s takeover of Accolade. But I’m not really here to talk about the digital health VC market per se.
What I do want to talk about is who is getting VC. This was prompted (to my slow Small Language Model) by a female friend who has been a CEO and was once a star at a fast growing digital health company. She told me that being female was now an active hindrance to raising money. Every time some tech bro on LinkedIn says how they raised $XXm in 12 minutes with no pitch deck, you’ll see lots of female CEOs explode in anger.
You don’t need me to repeat the numbers. Women & minorities find it hard to raise money. First time founders get a massive run around. Even when things were crazy in 2020-2022 the survey of startups I ran showed that it was very hard for early stage companies to raise money. Now it’s the apocalypse.
That’s not to say some female CEOs aren’t raising. Just last week Nema Health run by former Health 2.0 star intern (and now practicing Psychiatrist–which may be more relevant!) Sofia Noori raised $14m Series A to expand its amazing PTSD cure program. Maven’s Kate Ryder raised another $125m late last year to keep expanding their women’s health program, and must be viewing that elusive IPO sooner or later. And at a JPM party I ran into some of Joanna Strober’s team, reminding me that I thought Midi Health had perhaps raised too much money when it pulled down another $60m last year–but apparently it is going gangbusters. There’s also Equip for eating disorders with Kristina Saffran & Erin Parks at the helm (over $95m in so far) and doubtless a few more I’m forgetting. But in general they are the exceptions.
What’s not the exception is the tech bros raising for AI. Obviously the big players here are OpenAI, Anthropic et al pulling down billions to build their AI infrastructure. Anyone with a 401K is probably hoping that all works out given how much of the value of Nvidia, Tesla, Google, Meta, Microsoft & Apple seems to be based on a perhaps mythical AI abundant future. But there’s plenty in health care. Just this week Innovaccer ($275m), Qventus ($105m) & Truveta ($320m) all backed up the truck, all to combine data, AI and hope it will solve some of health care’s troubles.Those CEOs are men. But that’s not what I am complaining about.
You can also be a man and get away with a lot more. Hippocratic AI’s CEO Manjul Shah ran his last company HealthIQ into the ground. He screwed over suppliers, employees and customers to at least the tune of $17m in unpaid bills according to Katie Jennings at Forbes, then took another $170k personally out of the bankrupt company after he’d left. Was he a pariah to the investors who’s lost over $200m? Not in the least. The same investors A16Z and General Catalyst gave him another $50m right away to build an AI nurse chatbot company, and apparently health systems are lining up to buy it according to a podcast he was on with Julie Yoo of A16Z last week. This week Kleiner Perkins (and more) kicked in another $141m.
You might also have noticed that Ali Parsa who went through over $1 billion and crucified all his public market investors too when Babylon Health cratered is also back. His new company – an AI assistant launched with some famous doctors including Shafi Ahmed – is called Quadrivia AI. Funding isn’t clear but Sifted found some filings that indicate a Swedish VC is behind it.There’s also more than a little controversy about whether Babylon’s demise was just a series of bad business decisions or Parsa was lying about the tech. (I had Parsa on a couple of panels and always found him deferential and charming, but you can google Sergei Polevikov’s opinion!)
Look, unlike Lisa Bari at The Health Tech Talk Show, I love the idea of getting AI to answer patients’ questions, call them with information and generally use bots to add “abundance” to the health care workforce. I mean it’s just an extension of what Alex Drane and Eliza (and Silverlink & others) were doing 15 years ago. And there is huge possibility in using AI to actually diagnose and treat. I’m sure Parsa’s new AI bot also has the potential to improve physician care.
But should it be that easy for guys like Shah and Parsa to immediately get back in the game given the chaos they left in their wake? Shouldn’t VCs have some qualms about anointing as saviours the very people who just screwed over their previous customers, partners, employees and investors?
But I guess we have our answer already. Adrian Aoun took a big swing with Forward and closed it after losing $650m and leaving patients in the lurch with no notice and 200 people unemployed. He was back on a podcast days later saying his investors wanted to give him more to start again. And the biggest loser, chaos agent and conman of recent years, Adam Nuemann of WeWork infamy, was back very soon after with another $350m for yet another real estate startup.
Neumann’s benefactor in the latest round was A16Z’s Mark Andreesen. Andreesen also famously helped fund Trump’s election in 2024. That’s the biggest comeback of someone with no morals, ethics or competence ever.
So I guess at least some VCs have decided, there’s no shame.
(If you’re wondering about this piece’s title, I am riffing off this blues classic)
Some real medical innovation!
This may be the best comeback performance of all time. Not only did Lindsey Vonn come out of retirement to race a World Cup downhill at age 40 but she placed 6th and did it on an artificial knee! Here’s the details on the surgery but first watch her performance and just look how happy she is at the end!
