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arrativeDX is an Austin-based startup pioneering a socialbased feedback system that gives hospitals and clinics timely information about their patients’ experiences. The Dell Medical School at the University of Texas at Austin selected its inaugural class of 50 students this past summer. They are working to transform the way medical care is delivered. And the campus is flourishing with the Dell Seton Medical Center opening in May of 2017 and the creation of a healthcare innovation zone. And the Dell Medical School is looking to work with startups to improve patient care. New medical technology startups are sprouting up all the time in Central Texas and we’ve compiled a list of ten to watch in Austin and ten to watch in San Antonio. These are just a few of the stories you will read about in this third annual issue of Silicon Hills News focused on the life sciences industry in Central Texas. This issue is possible thanks to our advertisers: BioMed SA, Texas State University Small Business Development Center, bank SNB, the Greater Austin Chamber of Commerce, PotentiaMetrics, Novobi, Unaliwear, MPO Summit, InnoTech Austin, Moreland Properties and everyone else who has offered assistance and support. Silicon Hills News turns five years old in September. It’s amazing what we’ve been able to accomplish in five short years. We built our website up to 40,000 unique visitors monthly and our newsletter
and social media channels continue to grow with more than 10,000 collective followers. We completed two successful Kickstarter projects to launch the magazine and create an annual technology calendar. We’re also working to launch a weekly podcast. We’ve done all this as a bootstrapped startup with great empathy for the companies we cover. And all of our success at Silicon Hills News has been possible in a large part to our stellar staff of contributors including Susan Lahey, who has been with Silicon Hills News since the first month. Thanks also to veteran business reporter Tim Green who has contributed to every paper issue of the magazine. And last, but certainly not least, a big thank you to Hojun Choi, a journalism student at the University of Texas at Austin and a stellar reporter. He also contributed several stories to our last life sciences edition and served as Silicon Hills News’ first intern. And thank you to you, the readers, for your time and attention. We truly appreciate you.
Laura Lorek Founder of Silicon Hills News
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Silicon Hills News
Life Sciences Third Annual Issue Index 1 Overview of Central Texas’ Life Sciences Industry 2 Index 3 to 4 Dell Medical School startup culture 6 to 7 Dell Medical School Overview 8 10 Life Sciences Startups to Watch in Austin 10 10 Life Sciences Startups to Watch in San Antonio 11-12 Chiron Health 14-15 RX Wiki 17-18 ESO Solutions 19-20 Macromoltek 21-22 Q&A with Michele Skelding with the Austin Chamber of Commerce 23-24 NarrativeDX 25 Top Healthcare Accelerators
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Austin Seeks to Transform the Healthcare Industry By Laura Lorek, Reporter with Silicon Hills News
Twenty years ago, healthcare planners tucked research parks into suburban environments, away from the buzz of the city.
And the new Dell Seton Medical Center will open on May 17, 2017, said Greg Hartman, president of Seton Healthcare.
Today, innovative healthcare centers serve as the centerpiece of urban cores like the new Dell Medical School and the Dell Seton Medical Center and campus at 15th street and Red River in downtown Austin.
It’s about the same size as the existing Brackenridge Hospital but it’s built with the latest technology and it’s built to be a teaching hospital, he said.
“It’s about creating that nexus for people to come together and be adventurous that’s what we are hoping to create here,” said Dr. Clay Johnston, dean of the Dell Medical School at the University of Texas at Austin. The Dell Medical School wants to nurture an environment to improve healthcare with ideas from outside of academia, Johnston said. “It’s less about the knowledge it’s more about the adventurousness of the people,” Johnston said. “An adventurous attitude. Bring them together so that they are bumping into each other in ways that they wouldn’t in suburban business parks then great things happen. It’s been proven over and over again.” Johnston participated in a panel discussion on healthcare in Austin put on by Bisnow, an online real estate news site, recently at the JW Marriott in downtown Austin. Rick Rome, senior vice president with WSP+ccrd, a hospital development firm, moderated the panel, which focused on the Dell Medical District and Innovation Zone. Central Health will be redeveloping its 14.2 acres six block downtown Brackenridge Campus once the Dell Seton Medical Center opens in May of 2017, said CEO Patricia Young Brown. It has posted master plans to its website which include architectural renderings of its mixed use development and park. “We expect our property to serve as a hub of innovation activities,” Brown said.
“The rooms will be larger to allow students and residents to come into the space,” he said. “There are places for people to think and to have creative sessions.” The Dell Seton Medical Center will be focused on entrepreneurial activities and creating new revenue streams and businesses including joint ventures and startup companies through a new Seton Holding company, Hartman said. Business relationships need to be a part of phase one, Johnston said. But the overall focus is to provide excellent healthcare to everyone in Travis County, he said. The healthcare center aims to take a big picture approach to keeping people healthy by everyone working together as a team, Johnston said. “We need that business basis for the innovations to be able to plug in,” he said. The Dell Medical School’s health learning building opened this year and a new 300,000 square foot research building will be done in January, Johnston said. IDEO designers helped plan the buildings. The research building is connected by a bridge to Dell’s clinical building which will offer outpatient services with Seton and its health learning building. The clinic building will be completed in May of 2017. The first Dell Medical School class of 50 students began training three weeks ago. “We’re not creating a traditional medical school because there are a lot of those out there and they are stuck in the way they do things,” Johnston said. www.SiliconHillsNews.com - 3
“Our charge is different from the typical medical school and the opportunity we have to think about what healthcare could be is very different. We think our play is more about how we create an ecosystem to help others find solutions to health problems, not just healthcare problems, but also problems upstream,” Johnston said. “We will find ways in which they can be paid for their success. So this is inherently entrepreneurial which means our curriculum needs to look different. It also means the success of an innovation zone around us is absolutely critical to our success.” Digital health is going to be a key area in the future and one in which Austin can be front and center, Johnston said. “Life sciences is a hotspot in the community,” said Michele Skelding, senior vice president of innovation at the Austin Chamber of Commerce. The chamber and its members took field trips to look at innovation zones in other cities like Boston, San Francisco and Toronto, she said. They drew inspiration from those centers, but Austin is seeking to create something original, she said. “We are going to make this a true transformative aspect of the city,” she said. Austin is creating a healthier way of living by encouraging people to walk more, said Larry Speck, senior principal with Page architectural firm. Walking is at the center of the planning and design of the medical school, he said.
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In particular, Waller Creek, what has been a ditch that ran through Austin, is being transformed, Speck said.
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The Dell Medical School is “bringing, a green, soft quality, right into the middle of the school which isn’t true of most medical schools which are asphalt jungles, they are ugly, they are stressful, they are disorienting in a time when you are vulnerable and you shouldn’t be subject to that,” Speck said.
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It will also feature hike and bike trails and it incorporates Waterloo Park. The development will be certified under the sustainable sites initiative, he said. The district will have a place for people to live, work and have entertainment. It will also feature a 15 block pedestrian walkway that will go from 11th street to Dean Keeton that is a landscaped environment, he said. The district will have a bohemian vibe and will incorporate the music scene and all of Austin’s creativity, he said. “There’s no other place where we can attempt this big transformation,” Johnston said. It’s not just about the space and buildings, but the way the care is being delivered and the focus on keeping people healthy, he said. “We have this unique opportunity to transform the way health and healthcare are delivered,” he said. 4 - Silicon Hills News
Beth Carter Broker Associate, GRI
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Dell Medical School: a Catalyst for Austin Startups
By Tim Green, Special Contributor to Silicon Hills News
In July, after several years of preparation and construction, the Dell Medical School started instruction with its first class of students. The school, students and the Central Texas Community are walking hand-in-hand not only for a medical education, but to change how health care and medicine are done. Part of the Dell Medical School (DMS) and community interaction involves the Austin startup community. Silicon Hills News talked to Maninder “Mini” Kahlon, vice dean for strategy and partnerships, and Mellie Price, executive director of technology innovation who has been an Austin company founder, CEO, funder and mentor, about how the school intends to engage with the startup community.
Mini Kahnlon
Mellie Price
The interview has been condensed and edited. Mini Kahlon: From my perspective, enabling the entrepreneurial community here is very important to us. It’s a model of how academic medicine can relate to an entrepreneurial community so we would hope to learn some lessons to spread to other places.
The other program, The Health Technology Innovation Platform, is an opportunity for DMS to identify companies in various stages of development that are interested in pivoting their product offering or their service offering into value-based care. What DELL Medical School can provide to startups
My biggest success, so far, is the recruitment of Mellie Price into our ecosystem not only because of her own history as an entrepreneur and a CEO but also as an obvious catalyst already in the Austin ecosystem. Mellie Price: Two programs are helping turn research into health and medical products and services. The Texas Health Catalyst program helps University of Texas faculty and clinicians affiliated with DMS and Seton Healthcare. It provides consulting and funding of up to $100,000. The first requests for proposals covered comprehensive joint replacement and women’s health. The catalyst program received 83 proposals from some 30 organizations and a dozen academic institutions. 6 - Silicon Hills News
MK: Given the expertise not only of the clinical domain but our ability to pull together industry expertise, we will leverage the people who have seen products go to market over and over again within the domain, so they will get feedback on whether these people think that their idea or product has potential or not. If it does find a match within our care opportunities they get to be tested out within an actual clinical opportunity. That’s a very important de-risking. They can have their product used by leaders in healthcare and in these new models of healthcare. That’s part of what’s new is because we’re interested in products that help drive transformation. They actually would have proven their value within a real demonstration that includes a real payer (such as an insurer). Other payers will recognize that this was a real implementation with a real payer.
Those things in a real setting that is hard to get especially for those that want to produce products for the future of care and the connection to a sustainable funding model. MP: The medical school is really at the epicenter of creating these new models of care. When you move from putting the doctor at the center to putting the patient at the center of all the business processes around that change. All of a sudden you’ve got data inputs and software and things that need to be built that simply don’t exist yet. It’s health transformation at its root. So our innovation initiative has to encompass not just the traditional creating new molecules
The catalyst program received 83 proposals from some 30 organizations and a dozen academic institutions. for pharmaceutical opportunities and running clinical trials. It’s literally business process re-engineering.
DMS as a catalyst MK: What we’re working on is catalyzing the growth of health innovation in Austin. Our ideal metrics of success across various domains around health innovation are going to be the growth of this region almost independently of us. MP: You hear that this is the first medical school to be built in 4050 years tied to a Tier 1 research facility. But that’s not the cool part. The cool part is that it’s very likely to be one of the last ones because there’re no major metropolitan areas that don’t have a medical school and those medical schools are beholden to traditional healthcare. It’s extremely difficult to change your revenue model. We’re the lucky place on the planet that gets to work on this problem and really focus on how do we realign reimbursement incentives so that people are staying healthy longer and if they have to have a surgical episode, we’re reducing readmissions and improving the outcomes. It’s literally a once in a lifetime opportunity. If we can really get that message out to the community as a whole and galvanize the community around the opportunity to get involved. Maybe you’re not a doctor maybe you’re not an entrepreneur but maybe you’re a community leader that can raise awareness in your church or your school about ways to engage with this unique opportunity that we have.
TM
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10 Life Sciences Companies to Watch in Austin By Laura Lorek, Reporter with Silicon Hills News Austin is home to a small, but growing biotech and medical technology industry with about 200 companies, according to the Greater Austin Chamber of Commerce. That number is sure to skyrocket in coming years as the city feels the full effect of the new Dell Medical School at the University of Texas at Austin and the healthcare innovation zone being created in the downtown area. Right now, the city’s strength lies in medical device and diagnostics, biologics and biotech, contract research, pharmaceuticals and startups in a wide variety of areas. Here’s just ten local companies we’ve highlighted. Alafair Biosciences – The company, founded in 2011, a medical device startup, recently received FDA clearance for its first product, VersaWrap Tendon Protector. It is used in the treatment of tendon injuries. Earlier this year, the company closed on $2 million in funding to help roll the product out nationwide. To date, it has received $5.9 million in funding. Curtana Pharmaceuticals – The company, founded in 2013, moved from San Diego to Austin in 2014. The Cancer Prevention and Research Institute of Texas, known as CPRIT, awarded the company a $7.6 million grant to develop a drug for glioblastomas and other brain cancers. Lumos Pharma – The company, founded in 2014, is a clinical stage, biopharmaceutical company developing therapeutics for rare and neglected diseases. In April, Lumos completed $34 million in funding and planned to use the proceeds for clinical trials and commercialization of its lead drug, LUM-001, for the treatment of Creatine Transporter Deficiency, the second leading cause of X-Linked mental retardation in males after Fragile X Syndrome. To date, the company has raised $48 million, according to its profile in Crunchbase. PotentiaMetrics – The company, founded in 2010, relocated from St. Louis to Austin in 2015, and provides proprietary realworld outcomes registries and analytics platforms to reveal personalized and predictive insights. It is harnessing patient data to provide better treatments and outcomes for different diseases. Savara Pharmaceuticals – the company, founded in 2007, creates drugs to treat rare respiratory diseases. In June, it acquired the assets of Serendex Pharmaceuticals, based in Copenhagen, Denmark. Its lead product is AeroVanc, an antibiotic being 8 - Silicon Hills News
developed for the treatment of persistent MRSA infection in people with Cystic Fibrosis. The drug’s Phase III clinical trials are expected to begin later this year. In March, the company closed on $20 million in Series C financing. Spot On Sciences – the company, founded in 2014, recently received a $225,000 grant to support research for a preanalytical, endogenous standard to compare blood sample types. The company has developed HemaSpot devices to simplify collection, preservation and shipping of dried blood samples. The company also participated in the first ever White House Demo Day in 2015. Tevido Biodevices – The company, founded in 2011, is making nipples from human cells using 3-D printers for breast cancer patients. It has received funding through crowdfunding and a Small Business Innovation Research grant from the National Cancer Institute and a grant from the National Science Foundation. It is also a graduate of the Texas Ventures Lab at the University of Texas at Austin. TVA Medical – The company, founded in 2008, is a medical device maker developing minimally invasive therapies for patients suffering from end-stage renal disease. In late 2015, it completed a $15 million Series C financing. It plans to use that money to support clinical activities and commercialization of everlinQ endoAVF system, a catheter-based technology designed to create hemodialysis access for chronic kidney disease patients in a minimally invasive procedure. To date, it has raised $27.1 million in funding, according to its profile in Crunchbase. UnaliWear – The company, founded in 2013, makes the Kenega watch aimed at seniors that provides discrete support for fails, medication and reminders and guards against lost-wandering. Earlier this year, the company announced it had raised $3.4 million in seed funding. It has also joined forces with Maxim Integrated Products to make the watches. The company also successfully raised $110,154 from 306 backers on Kickstarter last year. Xeris Pharmaceuticals – the company, founded in 2005, closed on $41 million in Series C financing in January. It is using the proceeds to develop patient friendly injectables for treatment of diabetes, epilepsy and immunology. It plans to use the proceeds of the funding for Phase 3 clinical trials and commercialization of its G-Pen, glucagon injection program for severe hypoglycemia.
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Ten Life Science Companies to Watch in San Antonio By Laura Lorek, Reporter with Silicon Hills News San Antonio has a robust bioscience and healthcare industry which contributes more than $23.9 billion to the city’s economy annually, according to the San Antonio Economic Development Foundation. In fact, one in every six San Antonio employees works in the bioscience and healthcare industry. The industry is constantly creating new jobs and its startups and innovative bioscience companies are key to its continued growth. Here’s ten companies with cutting edge research and products worth watching in the coming year. BIO2 Medical – The company, founded in 2007, has created the Angel catheter, which provides access to the central venous system and traps blood clots before they reach the lungs. It completed clinical trials last year. The U.S. Food and Drug approved the device in July. The company also recently received funding to roll out its product. To date, it has received $51.2 million in venture capital, according to Crunchbase. Bluegrass Vascular Technologies – The company, founded in 2010 in Kentucky and relocated to San Antonio in 2014, has created the Surface Inside-Out Access Catheter System. It announced on Aug. 30th that the company received CE Mark approval and is launching limited commercial sale of its medical device in Europe. The company also announced the U.S. Patent and Trademark Office recently issued two patents related to Bluegrass Vascular’s technology for its catheter system. The company has raised $4.5 million so far. Cytocentrics – The company, founded in Rostock, Germany in 2001, moved to San Antonio last year. It specializes in cellular patch clamp testing. “Patch clamping is a technique for measuring microscopic voltage changes caused by the movement of molecules through the membrane ion channels of a cell, a function that is central to cellular physiology and drug-cell interactions.” With the company’s patch clamp technology, drug makers can develop better medicines. Its instrument, known as the Cytopatch 4, is available for sale worldwide. Invictus Medical – The company, founded in 2010 by University of Texas at San Antonio students, created a medical device known as the GELShield. It provides extracranial pressure relief for
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newborn babies. Invictus received FDA clearance last year and is now selling the device nationwide. Mobile Stem Care – The company, founded in 2013 by a University of Texas at San Antonio student, provides stem cell therapy to pets. It uses adult stem cells, taken from the animal, to treat traumatic injuries, degenerative diseases, non-healing wounds and other ailments in pets. Nebulab – The company, founded in 2014, has created a contextual data management portal for scientists. It’s a platform for research scientists to store and manage data and papers. It spun out of a 3 Day Startup program and received an initial $25,000 investment from the Geekdom Fund. It went on to participate in the 2015 Techstars Cloud program. The company has raised $253,000 since its inception, according to Crunchbase. Fe3 Medical – The company, founded in 2008 in San Jose, announced in August that it raised $14.5 million in Series B funding, including $3.5 million from the State of Texas. The company is developing a transdermal patch that delivers iron across the skin for patients suffering from iron-deficiency anemia. Fe3 Medical, an InCubes Lab company, moved to San Antonio in 2010. Pronucleotein Biotechnologies – The company, founded in 2005, won the runner up title in last year’s first ever U.S. Food and Drug Administration Food Safety Challenge. The received a $100,000 prize for their portable rapid pathogen screening system. The device is aimed at making e-coli, listeria, campylobacter and salmonella detection easier and faster. Rapamycin Holdings – The company, founded in 2012, makes drugs to slow the aging process and to treat age-related diseases in people and animals. It raised a $2.5 million Series A round in 2015. It licensed the formulation of rapamycin from the University of Texas Health Science Center at San Antonio. Xenex Disinfection Services – The company, founded in 2008 in Austin, moved operations to San Antonio a year later. It makes a $100,000 robot that eradicates dangerous bacteria and viruses in hospitals and clinics by using pulsed Zenon UV light to disinfect patient care environments.
Chiron Health Lets Doctors Get Paid for Telemedicine Services By Hojun Choi, Reporter with Silicon Hills News When Charlie Kolb, co-founder of telemedicine startup Chiron Health, made the decision to enroll in classes for his master’s degree at the University of Texas at Austin, he did so with the dreams of one day starting his own company. “I wasn’t interested in investment banking, or consulting,” Kolb said. “I was very focused on starting a company and I wanted to meet people who wanted to do the same.” Kolb got significantly closer to achieving his dream when he met fellow classmate Andrew O’Hara, the founder and CEO of the Austinbased startup, who was looking to bring his experiences from the health information technology industry into the startup world. O’Hara, who had worked as a stock analyst in Chicago, told Kolb about a gap in the telemedicine space, which had previously been bogged down by regulations that made it difficult for physicians to receive reimbursements for telemedicine services. Though telemedicine companies like American Well and Teledoc were garnering positive buzz about their services, Kolb said O’Hara envisioned a service that would help doctors connect with their existing patients, rather than offering a platform that locates a physician for the customer. “[O’Hara] said a bolt-on telemedicine solution that plugs right into the systems that are already installed in basically every doctor’s office in the country would be a good strategy,” Kolb said. With their compass pointing North, Kolb and O’Hara began developing their venture. In addition to taking graduate-level courses, the two-man team began putting together pitch decks and started their initial market research. With their concept in mind, Kolb and O’Hara participated in “3 Day Startup,” a workshop hosted by the Austin Technology Incubator. “We had some phenomenal research on reimbursement and
regulations -which are two big hurdles for practices when adopting telemedicine,” Kolb said. Their vision caught the attention of fellow participants in the three-day workshop, which places individuals into teams and pairs them up with advisors who help teams conduct market research and develop business models. The workshop became a launching point for Kolb and O’Hara, who now looked to Charlie Kolb develop a minimal viable product to pitch to investors. Shortly after the success at the workshop, O’Hara told Kolb that he would be leaving the master’s program -a decision that Kolb would later make himself. “I think you can get some great experience from learning in a classroom, but it’s nothing compared to the hands on experience you get from building and operating your own company -so no regrets, really.” Kolb said. By late 2013, Kolb and O’Hara had found a developer to create the first version of their telemedicine platform, and by the summer of 2014, Chiron Health had 12 customers using and paying for their platform. “What we were selling fit into a viable economic model, and I think a big part of that was the fact that these were visits that they could get reimbursed for,” Kolb said. Through their market research, Kolb’s team learned that doctors conduct a large volume of visits over the telephone on a daily basis, many times for post-hospital care for outpatients. Kolb said that www.SiliconHillsNews.com - 11
At that time, insurance companies were not reimbursing for telehealth, so their biggest selling point is probably the fact that they take care of the reimbursement though these services over the phone were frequent, doctors could not be reimbursed for the time they spent for these remote visits.
She said the company’s platform has not run into any technical issues, and said the company’s costs have not been taxing on her practice.
If these same visits were conducted over a video conference call, however, physicians are able to collect reimbursements for their treatment.
“If there were any problems, they were on the patient side, and they were rare,” Guerra said.
“Most physicians, regardless of where they are, are not aware there are laws that require that video visits be reimbursed,” Kolb said. “Doctors just think you can’t get paid for them, so a lot of our job on the sales side is educating and spreading awareness around those regulations.”
Guerra said Chiron Health’s customer support service allows her patients to deal with any questions or problems they have with the software, and she had not received any complaints about the platform.
Kavita Radhakrishnan, a nursing professor at the University of Texas at Austin, specializes in telehealth, and has conducted research on the effects of telehealth on patients. She said the issue of reimbursement was a large barrier for many practices trying to adopt telemedicine technologies during her research. “At that time, insurance companies were not reimbursing for telehealth, so their biggest selling point is probably the fact that they take care of the reimbursement,” Radhakrishnan said. In the past, Radhakrishnan said that healthcare providers were also wary of the costs related with upgrades needed to maintain telemedicine platforms. “Telemedicine definitely has value which is why being aware of some of the negative aspects and being prepared for that is really going to increase the value of telehealth,” Radhakrishnan said. Dr. Adriana Guerra, who owns a family health practice in central Austin, said she has been using Chiron Health services for almost two years.
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“If I feel like a patient is struggling with getting online or logging in, I can use the ‘help’ button to get in contact with the customer service team to reach out to the patient immediately,” Guerra said. The company, which recently competed in “Google Demo Day” in May, has raised more than $3 million in funding. Kolb said that Capital Factory’s incubator program has greatly helped the company gain the momentum to attract more institutional funding. And despite having received very few complaints about their telemedicine software, Kolb said the company looks to use the money to further streamline their platform. “You can make a change on the product that directly impacts our ability to sell, or our ability to provide better customer support.” Kolb said. “We’re very comfortable with the foundations that are in place, so we feel like we can get the most leverage out of investing more in the product at this point.”
ADVANCED TECHNOLOGIES TODAY for a Healthier Tomorrow Austin’s growing cluster of innovative life sciences companies embrace the area’s technology infrastructure. The result? A region of established and emerging companies that are changing the face of healthcare. To tap in to Austin’s emerging HealthTech cluster for market overview, sector development and connectivity, please contact: Arthur Jackson, Director, Economic Development: ajackson@austinchamber.com | 512.322.5611
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RXWiki Helps Indie Pharmacies Compete with The Big Boxes By Susan Lahey, Reporter with Silicon Hills News For most people the concept of the “corner drugstore,” with or without a soda fountain, is a quaint anachronism befitting the movie “It’s a Wonderful Life,” but not modern society. In fact, though, there are more than 22,000 small, independently owned pharmacies in the U.S. Some will still make you a Black Cow. Many will mix up your medications right on site without the gluten, lactose or other binders that make some patients sick. RXWiki was launched to help those little pharmacies. RXWiki is essentially a digital marketing company for independent pharmacies. The company’s website offers a “medication encyclopedia” written by pharmacists, news updates around medical issues and medications, and encyclopedic content around medical conditions, similar to a WebMD site. It has more than 20,000 original articles, 7,500 health-related videos, 100 disease condition channels and co-pay assistance programs. More than 5,000 community based pharmacies use its content. But its primary function is to create websites, mobile apps—including medication reminders--and handle social media and content for the independent pharmacies who fill a niche among the big boxes. RXWiki runs a software as a service platform that supports 1,300 specialty and community websites, mobile applications and newsletters. Chris Loughlin RX Wiki raised $5.75 million in funding last October from investors including LiveOak Venture Partners and Milestone Venture Partners LP. The company hired Chris Loughlin as its CEO last February. Today, most medications are pretty standardized—coming in doses of a specific number of milligrams--and don’t serve people who might require a higher or lower dose, Loughlin said. Nor do many pharmacies offer compounding services in which pharmacists will create medicines without ingredients patients don’t tolerate well. While many people may never meet their pharmacist, independent pharmacists strive to play a role in patients’ medical care, ensuring they’re getting their medication and following doctors’ orders.
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As “designer drugs” become more popular and we learn more about our individual bodies’ reactions to medications, the role of such specialty pharmacies might increase dramatically. But today, it’s tough to compete when small pharmacies can’t be open 24/7 like a lot of big chains. RXWiki tries to level the field through mobile apps where patients can order refills at any time. A new feature of the app is to set up reminders at the appropriate times to take medications purchased through the pharmacy.
THE CORNER DRUGSTORE GOES DIGITAL Austin’s MedSavers is one of these specialty pharmacies. Owner/ pharmacist Chris Johnson says he may be the only one left with his business model. He doesn’t take insurance; but he does claim to have much lower prices than his competitors. Johnson had worked for the big boxes for years and was frustrated with the prices they were forced, by agreements with insurance companies, to charge for medications. One of the worst he remembers was an anti-nausea medication for chemotherapy patients that cost only $20-$30 for a bottle but he was supposed to charge closer to $1,000. So he launched his own, independent pharmacy. He only wanted a website, but RXWiki offered a lot of other services for little or no extra charge. That was a deal he didn’t want to pass up. CEO Loughlin knows all about supporting independent businesses in a world of giants. The co-founder of Weekends.com, an internet travel company, his business was purchased by Travelzoo in 2001. Loughlin worked his way up, eventually serving as Travelzoo CEO from 2010 to 2015. Because of his background he could look at the problem with “different eyes.” For example, while many pharmacies were getting apps, few of their customers were downloading the apps. It just never occurred to them. So Loughlin, thinking of the buttons worn by airline staff, suggested pharmacists and sales associates wear buttons to remind customers to download the app. The added technology is meant to augment, not replace, service in the independent pharmacies, he said. For example, RXWiki might
We had customers who went to different pharmacies because, they would tell us ‘I forget to call you when you’re open.’ They don’t have to remember now. offer a quiz on a particular condition and discover that patients who have that condition actually know very little about it. That can allow RXWiki to share more information about the condition and alert the pharmacist that their patient doesn’t really understand their medical condition, so the pharmacist can take proactive steps to help. In Remington, Virginia, population 615, pharmacist and co-owner of Remington Drug Al Roberts knows his customers pretty well. The pharmacy, which has been there since 1913, is the place to go when you want to know what’s happening in Remington. But it’s also a bedroom community for Washington, D.C. and a lot of residents work in the city. They don’t make it in to order refills when the pharmacy is open. Having RXWiki has helped a lot of customers connect with the pharmacy, Roberts said. “We had customers who went to different pharmacies because, they would tell us ‘I forget to call you when you’re open.’ They don’t have to remember now.” The store receives faxes at all hours of the night coming in from people’s apps. “It removes one more blockade from the patient to us.” Of course, he said, he also gives people his cell number so they can call if they’d rather do that. “I tell them ‘I’m available to you 24/7.” www.SiliconHillsNews.com - 15
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We build platforms to support comparative effectiveness analysis and improve healthcare outcomes.
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ESO Solutions Aims to Improve Patient Care By Hojun Choi, Reporter with Silicon Hills News The culture Chris Dillie has implemented into his company is simple: be passionate about what you’re doing, and the money will follow. ESO Solutions, a health data exchange startup, provides software to help ambulance services better monitor their performance, and helps hospitals use that data to improve patient care. The Austin-based company started in 2004, when Dillie, its CEO, decided to drop his real estate business to follow his passion of helping people in need. Before he began investing in real estate, Dillie served as a volunteer firefighter and an emergency medical service paramedic. “I really enjoyed helping people,” Dillie said. “At the same time you’re put in situations where you’re forced to think a lot; you’re constantly solving puzzles.” After spending time as a paramedic, Dillie also worked as a manager of an EMS station, where he was in charge of quality control. “We had a really hard time knowing how well we were providing services because we didn’t have data,” Dillie said.
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It was during this time that Dillie’s real estate business became too large to juggle with the managerial position at the EMS station. However, When John Dadey, who would serve as the president of the company, approached him with the idea of developing what would become ESO Solutions in 2003, Dillie could not resist. “The reason I left real estate is because this very quickly became my passion,” Dillie said. “I saw what the market could hold and I was really passionate about how our product could change the industry.” In order to address the gap that Dillie learned of as a manager of a EMS station, ESO Solutions offers software suites that allows for data exchange between hospitals and EMS providers to ensure higher quality care. From the moment a 911 operator is contacted to provide emergency services, the company’s software tracks what type of diagnosis is made, as well as what types of treatments and medications are given to the patient on-site. As the patient is passed along to a hospital, the software also helps deliver that data to the hospital to see what mistakes -if any, were made during that process. Because many hospitals use different types of databases to maintain their patient information, ESO Solutions translates that data into language that can be used by both EMS services as well as hospital systems. Allen Johnson, the company’s vice president of health data exchange, said that previous forms of monitoring performance was based on a flawed system.
Johnson -who like Dillie, also has a background as a paramedic, said that prehospital ambulance services have changed over the years, making data exchange and analysis more pertinent to quality service. “I think it’s a maturation of the industry,” Johnson said. “Over the last ten years or so, we went from medical directors being a local person who is nice enough to volunteer to many ambulance services today having directors that are on-site, full time.” Kenny Schnell, the director of Williamson County Emergency Services, said that his station has used ESO’s data exchange software for three years. He said the software has helped not only the station, but the region that his station serves, manage their performance. “Paramedics want to know how well they did,” Schnell said. “Getting the outcome data is big, because we want to see if we were on the right page.” With the outcome data, Schnell said EMS stations can learn how to better educate their paramedics and come up with effective solutions for concentrating time and resources in the areas of care that are lacking. ESO Solutions has more than 100 employees in the Austin area, and on July 12, announced an investment from Accel-KKR, a private equity firm with a focus in technology. Though the terms of that investment were not publicly disclosed, Dillie said the money will be used towards further developing the company’s software suite, as well as for team expansion. “Again it’s the culture we have here,” Dillie said. “If you follow your passion, and do what you do passionately, money tends to follow.”
“We were measuring performance of paramedics based off of what we thought was wrong with the patient with no way of being able to tell if our diagnosis was correct in the first place,” Johnson said.
“The reason I left real estate is because this very quickly became my passion,” Dillie said. “I saw what the market could hold and I was really passionate about how our product could change the industry.”
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This Fast Software Can Whip You Up an Antibody
By Susan Lahey, Reporter with Silicon Hills News
Monica Berrondo pulls up a digital schematic of an antibody. It resembles remnants of different-colored ribbon stuck together by someone with no sense of design. Each color and bend represents information about the amino acids that comprise the antibody, explains Berrondo, whose company, Macromoltek, made this model possible. If the antibody shown in this image works, it may one day be deployed in the body of a sick person, where it will hunt down and cling to a specific pathogen. There, this colored squiggle may stimulate the immune system to go after the pathogen, mark it as an enemy for other immune system cells to take out, or attack it outright. Antibodies, unlike many older pharmaceuticals, don’t have to carpet bomb healthy cells to attack specific pathogens. They’re efficient.
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It used to take months to design an antibody like this, just to get it to the point where it could be created and tested. With Macromoltek it takes hours. Researchers who subscribe to Macromoltek can log in to a secure workstation on the website and design a digital antibody using color-coded amino acids to read and track the sequence. The digital model helps researchers evaluate and edit their work, since one error can mess up the entire sequence. In general, Berrondo said, scientists will design maybe 10 antibodies that they hope will destroy a specific pathogen. They choose the best to go to a lab to be created and tested. But the digital design process significantly reduces both the time it takes to create an antibody, and the labor to test multiple iterations. Other companies have similar digital design capabilities, but Berrondo said Macromoltek is the only one she knows of that focuses on the creation of antibodies. The company has another distinction: it is the only one that lets researchers “humanize” antibodies that were originally created using mice. USER FRIENDLY SCIENCE SOFTWARE Berrondo is a graduate of Johns Hopkins University where she received her PhD in chemical and biomolecular engineering. “I’ve always been a computer person,” she said. “I did a lot of internships in high school and I hated the applications. I didn’t find them very meaningful. So starting out in college I wondered ‘How can I find a software project that’s meaningful?’” She found the answer in computational biology and molecular modeling, using computers to help researchers solve medical problems. She also knew she wanted, one day, to start her own company. During her post-graduate work, while she was serving as a software consultant for laboratories, she got the inspiration for Macromoltek. Most of the software laboratories were working with were difficult to use, for a lot of reasons. Some were too clunky and complicated, some too slow to do the calculations, some didn’t support object design, and so forth. Berrondo found herself returning to the same labs over and over to solve the same problems. So she launched into extensive market research to understand whether labs even used digital design—most didn’t—and if not why. She also asked the ones who did use it what issues they were having. Ultimately, she knew what she needed to make and spent six-to-nine months writing the software. To find out if her software worked, Berrondo collaborated with the University of Texas on validation studies, designing antibodies and having them produced in the lab. With a dozen or so verified and another dozen in the works, the real world seems to be bearing out her software’s efficacy. “Their protein modeling capabilities have provided us with a novel and reliable alternative to costly and occasionally challenging wet-lab 20 - Silicon Hills News
experiments,” said molecular biologist Curt Hewitt of Signature Science, an Austin based subsidiary of Southwest Research Institute and Macromoltek customer. “Working with them has allowed us to focus on the bigger-picture scientific problems at hand with the confidence that the modeling and technical assumptions we’re operating under are solid.” Last spring, Macromoltek became a Capital Factory Accelerator company. Since it was the accelerator’s first life science company, adviser Gordon Dougherty said he focused primarily on company strategy, customer acquisition, pricing and similar issues. Berrondo hired her mother, Susana Kaufman, a chemical engineer and software developer with experience in the financial services industry as her CFO. “Monica is a quiet lion,” he said. “She’s reserved in her demeanor but unbelievably smart. When she asks a question, it’s a question with a purpose. I really respect that about her. I meet with a lot of entrepreneurs who shoot from the hip. She is different, in a good way.” Though Berrondo has received grants, including recently receiving a National Science Foundation Phase II funding for $750,000 over the next two years, Dougherty said, she has come a long way without receiving investment money. “She’s waiting until she proves things out to a certain level across her business plan. That’s hard to do. It takes a lot of patience.” Now if she could design a program for that….
“I did a lot of internships in high school and I hated the applications. I didn’t find them very meaningful. So starting out in college I wondered ‘How can I find a software project that’s meaningful?’”
Q&A with
Michele Skelding with the
Austin Chamber Q. In your role as Senior Vice President Global Technology and Innovation what are the goals you wish to accomplish? MS: I work on behalf of Austin’s Economic Development Corporation and Opportunity Austin with the Greater Austin Chamber of Commerce. I lead the organization’s vision for Austin to be a top global region for technology and health care innovation, company formation and expansion, in addition to increasing access to venture capital, private equity and attracting top talent. In this role, my primary function is to provide leadership to cultivate emerging and strategic economic dynamism in the Greater Austin region. This focus on next generation technology and innovation trends aim to continue to seed and drive the long-tail of Austin’s sustainable and prosperous economic growth. Q. What are the biggest challenges you think Austin faces right now? How is the Chamber working to overcome them? MS: Over the past 15 years, Austin has seen many highs and lows. Austin in the late ’90’s was living large. The technology industry was at its peak, driving a booming economy throughout Central Texas. A few years later, that boom turned bust for the U.S., and Austin’s economy took one of the most profound hits. To combat our economic pains, business and community leaders in Austin created a public-private initiative with the goal of building and diversifying our economy. Opportunity Austin, has since been the driving force behind notable improvement in job, wage, salary,
and high-tech growth among the nation’s 200 largest metro areas and benchmark communities. We have not just survived, but thrived despite the 2009 economic crash and resulting recession. Today, Austin continues to have several foundational advantages: a central location, favorable tax climate and most importantly one of the most highly-educated workforces and incredible talent pipelines in the country. On top of that, Austin is continually recognized and branded as a place for innovation, growth and lifestyle. Entrepreneurs and the entrepreneurial spirit are powering so much of what makes Austin’s current economy so exciting. Q. So how do we extend our current success for the next decade? MS: A large part of our success now and in the future will depend on our curation and support of our rich culture of music, creativity and our innovative spirit of collaboration. Nurturing the “Soul of Austin” must be embedded in every aspect of our growth and development and how we build the future of the city we love. Tactically, one of the greatest opportunities Austin has, is the creation of a new blueprint for Austin to support the next-gen, innovation-based economy. We can optimize our growth by leveraging our strength in Tech with the opportunity to revolutionize healthcare. This convergence of Health and Tech by advancing innovation from discovery to outcomes and improving health in our community, can act as a prolific job creator and as a model for the nation if we get it right.
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At the heart of our economic growth strategy is the opening of the Dell Medical School and Dell Seton Medical Center at the University of Texas Austin (UT), and the Central Health Brackenridge Campus redevelopment. Q. What is Austin’s life sciences industry like right now? MS: Austin is home to best-in-class research facilities and boasts one of the most educated populations in the U.S. The dynamic, creative and entrepreneurial environment is fueled by the availability of funding, research collaboration, clinical trials, and skilled talent. Dell Medical School at the University of Texas at Austin, welcomes its first class in 2016, transforming the local economy as dramatically as the semiconductor and dot.com industries did in previous decades. Through a mix of strategic relocations and continued support for our existing industry, Austin’s life sciences cluster has evolved into a well-rounded representation of the industry as a whole. Over 200 life sciences companies in the region, and a workforce of nearly 12,300 is focused on the highest growth segments and research areas in the industry, including the specialties of biologics, medical devices, diagnostics, pharmaceutical, contract research, and others. We’re in good company: more than 3,700 companies with 93,800 workers make the State of Texas one of the leading biotech states in the country. Austin’s Life Sciences Industry • Medical device/diagnostics (33%) • Biologics/biotech (12%) • Contract Research Organizations (17%) • Pharmaceuticals (16%) • Other (22%) Q. Does Austin have enough talent in the life sciences field to support the growing industry here? MS: In the Austin metro area, you’ll find a combined enrollment of 177,000 students in four-year and community colleges. This provides an ample supply of well-educated workers to area employers. The student population within 100 miles of Austin exceeds 414,000, providing one of the world’s strongest talent pools. Life and physical scientists number over 4,500 in the metropolitan area’s workforce— approximately 43% of those are in life sciences fields. With a strong talent pipeline and rapid emerging growth surrounding our development and growth phase, Austin will continue to add a deeper bench of talent that will be attracted to the unparalleled new opportunities, as we set our vision as a model healthy city of Healthcare innovation. Q. What is going to set Austin apart from other healthcare centers around the country and world? What are the key factors we need to accomplish this vision? MS: Leveraging the creative spirit of Austin that itself in innovation is key to this success. Collaboration is key. Both inter-industry and inter-organizational collaboration is essential to the success of the community. Austin’s current high-growth industries within technology – creative/digital media, data management and life sciences/healthcare – have natural 22 - Silicon Hills News
synergies that can create a whole greater than the sum of its parts, if proactive collaboration is sought. Investing in knowledge communities. The importance of knowledge communities cannot be overstated, particularly in the life sciences field. The primary source of funding for medical research comes from the National Institutes of Health, which has been consistently declining in recent years, driving the need for additional autonomous research pipelines. Austin is working towards the creation of an innovation growth strategy that seeks to provide research testing facilities and incubators for early stage life science companies. Everything rests on talent. Talent supply is the currency of innovation. While Austin has among the strongest workforces in the country –since 2000, more than 225,000 people with a bachelor’s degree or higher have moved to Austin – we must do more, particularly in the realm of middle class job creation and re-training. Programs at UT and Austin Community College (ACC) are pioneering efforts in shortterm skills certification, and have an opportunity to provide far greater resources with their recent expansion and enhanced offerings. Know your strengths – and be honest about your challenges. Austin has a unique opportunity to approach the next phase in its evolution in a way that’s exclusively Austin – focused on lifestyle and a thoughtful, creative and inclusive community. Austin should focus on being a better Austin, not becoming Silicon Valley. Austin has phenomenal things happening in music, art, technology and culture, and projects should stitch all of those things together. A current challenge for Austin is a gap in the talent pool focused on life sciences, but convergence from its strength sectors within technology will go a long way towards influencing digital and software driven innovation that has applications in healthcare. There is a national opportunity to transform the medicine and life science sectors. While the “IT and Informatics Revolution” has escalated massive innovation in industries like banking, communications and media, making inroads in the healthcare industry has proven much more difficult, with “a broken innovation system”. For multiple reasons, healthcare has been notoriously resistant to technology advances. As a country, we spend more than any industrialized nation on healthcare, but our health outcomes are roughly equivalent to that of Cuba. New, collaborative research organizations that cross sector and industry lines offer the opportunity to be at the forefront of this transformation. Q. What other ingredients does the city need to create a thriving life sciences industry? MS: What we choose to invest in now will shape Austin’s future prosperity, and seizing opportunities presented by a new Tier-1 research medical school and teaching hospital and a thriving, hungry creative community, is a great first step. To address and build the innovation economy, we must collaborate, continue enhancing our workforce and build private capital. Most importantly, we must continue with collective passion and fire, to accomplish this big, bold vision and opportunity.
Kyle Robertson
Senem Guney
Transparent Patient Experience in Real Time By Susan Lahey, Reporter with Silicon Hills News If you have a bad experience at a hospital—and just having to go to the hospital is often a bad experience—you may write a letter of complaint, post something in social media or blast the hospital on your patient survey. And there’s a good chance that if someone got around to reading it, it would be long after you were gone. That sucks for the patient, but also for the hospital. According to a May survey by Accenture, hospitals that can provide superior patient service show up to 50 percent more in net margins than hospitals without it. Plus, if you’re a hospital with low patient satisfaction ratings, Medicare and Medicaid will reduce your reimbursements. So there are a lot of reasons why optimizing patient experience should be of enormous importance to everyone. Recently, the two Austin founders of NarrativeDX figured out how to do it. NarrativeDX uses natural language software to process everything from patient surveys to letters, phone call transcripts, and comments
on social media. It can “read” this information and identify key issues in the hospital that can be as broad as a cleanliness problem in the hospital and as specific as the bedside manner of a particular provider. Historically, hospitals relied on patient satisfaction surveys from Press Ganey, but that took forever. “You wait one to two months for patient experience surveys from Press Ganey,” said Geoffrey Hall, a NarrativeDX advisor who uses the service as administrator of Rusk Rehabilitation at New York University Langone Medical Center. “When I first started doing the pilot (with NarrativeDX) the information came back in 24 hours. Now it’s almost instantaneous. It can mine and capture data and map that out…now we might actually resolve the issue while the patient is there. It’s a game changer for me.” Shawn R. Smith, chief patient experience officer at Christiana Care Health System in Delaware said that, with the volume of feedback they collect, he said, it would be impossible for even a team of people to compile themes from the information they receive. Narrative DX does it almost instantly and can identify problems in myriad areas. www.SiliconHillsNews.com - 23
“When looking at medications and adherence (a patient’s willingness to take meds according to instructions) to patient side effects, you can learn that a particular side effect has a lot to do with this one medication. You can go very granular. And you might never have thought that these side effects would be connected with this medication.” PATIENTS TELL THEIR OWN STORIES One of the big advantages of NarrativeDX is that it lets patients tell a story about what happened. Too often in filling out patient surveys, there is no box to mark for the issue they faced. NarrativeDX co-founder Senem Guney did her master’s and doctoral work at the University of Texas studying the communicative fabric of work organizations and the issue of high-technology innovation in complex, multi-site organizations. Part of her studies included researching the importance of personal narrative in getting the message across. At hospitals, she said, the most important thing to patients is empathy, compassion. Patients consistently rank that higher even than providers’ knowledge. And that’s easier to capture in a narrative. Co-founder and CEO Kyle Robertson said the team did a deep dive into patient experience before launching in 2014. “We did a lot of research before to find out what’s important about patient experience: What about listening, empathy, compassion, kindness? What’s important about meals? There is this huge tree of all those things that are important.” Robertson has degrees in computer engineering, economics, and math from Iowa State University and a juris doctorate from Boston College Law School. “We plug these into machine learning algorithms that actually learns new stuff. It categorizes the comments and builds off that. It takes the human bias out of it…. It basically marries the insights from qualitative date with scaleability of quantitative.” NarrativeDX has its own “smart survey,” known as adaptive rounding, that is used when someone from the hospital makes patient rounds and asks about their experience. It can add questions based on previous responses. For example, if many patients complained about dirty showers in the rooms, it will add a query about whether patients were satisfied with the cleanliness of their showers. Both Robertson and Guney worked for major institutions before embarking on the entrepreneurship journey. Robertson worked for National Instruments and was an IP attorney representing organizations including Cisco and Apple, before starting his first company. Guney served on the faculty of State University of New York and was a Fellow at the Center for Technology in Government, a SUNY Albany think tank. NarrativeDX was accepted into DreamIt Health accelerator in Philadelphia in 2014. They received $50,000 as part of the incubator and have since raised $1.35 million from angels, Live Oak Partners 24 - Silicon Hills News
and Capital Factory. They will be working on a $3 million series A in the fall. Since they returned from Philadelphia, they said, they noticed a big improvement in the ecosystem for medical startups. For example, Seton’s hiring of national virtual care pioneer Dr. Kristi Henderson as an advocate for medical innovation. But Austin has a long way to go to catch up with the northeast in terms of support of innovation and tech startups in the healthcare system. Part of the problem is that the sales cycle in hospitals can be “long and brutal,” Robertson said. There are so many different people who have to sign off on any innovation. With help from people like Dr. Henderson, the Dell Medical School and proposed Innovation Zone, they said, the next generation of startups should find it a lot easier. Maybe Austin needs a NarrativeDX for entrepreneur experience….
We did a lot of research before to find out what’s important about patient experience: What about listening, empathy, compassion, kindness? What’s important about meals? There is this huge tree of all those things that are important.
The Top Texas Healthcare Accelerators and Incubators AthenaHealth More Disruption Please – Austin - this accelerator provides seed stage capital and access to healthcare experts and exposure to clients. It also provides workspace in downtown Austin and mentoring and other tailored programming. Companies are admitted on a rolling basis. The accelerator generally lasts seven months to a year. AthenaHealth also recently acquired Patient IO, an Austin-based startup, that participated in its program. Austin Technology Incubator’s Health and Bioscience Program – Austin – this accelerator is based at the University of Texas at Austin and is a program of UT’s IC2 Institute. It is more than 25 years old and is Austin’s oldest incubator and one of the oldest in the country. It doesn’t provide funding but has connections to many angel and VC investors and a vast network. It does provide coworking space, mentoring and lots of other programs. Startups are admitted on a rolling basis. Capital Factory – Austin – This accelerator is not solely focused on the healthcare industry, but it has many healthcare startups that got their start there like Chiron Health and Macromoltek. It provides co-working space and access to capital and mentoring, networking and other programs.
Texas Health Catalyst – Austin – this is the newest accelerator in Austin as the Dell Medical School at the University of Texas just admitted it inaugural class in June. This is just for Dell Medical School clinical affiliates, UT Austin faculty members and Seton healthcare clinicians. The program, administered by the Dell Medical School, provides up to $100,000 in seed stage financing for one year. The program accepts applications in June. Health Wildcatters – Dallas – This accelerator is on its fourth class of startups. Its program runs for 12 weeks each Fall. The program provides $30,000 in seed investment for an 8 percent equity stake, co-working offices in downtown Dallas, meeting spaces and access to a network of mentors. It culminates with the Pitch event at the end. TMCx - Texas Medical Center Accelerator – Houston – This accelerator, located at TMC Innovation Institute, gives startups workspace, tailored programs, access to 120 advisors. It doesn’t take any equity or charge membership fees. It is a four-month long program that ends with a Demo Day.
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Step into the future Undergraduate and graduate programs offering unique interdisciplinary learning experiences in medical�, dental�, science�, and engineering environments www.SiliconHillsNews.com - 27
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Heroes cHampioned san antonio. tHey still do. San Antonio was founded by larger than life heroes who gave their lives for something bigger than themselves. Today as America’s 7th largest city, San Antonio is a leader in trauma care, wound healing and regenerative medicine to benefit the nation’s wounded warriors and civilians alike. Through our collaborative spirit, we are combining a diversity of talent and unique research assets that are making a global impact on science, health and life itself. Which is why innovations that save lives around the world are being developed here.
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