Google In Healthcare

Mar 17, 2018 | Publisher: Techcelerate Ventures | Category: Health & Medical |  | Collection: HealthTech and MedTech | Views: 274 | Likes: 2

1 How the tech giant is attacking the healthcare space Google In Healthcare 2 The presentation will also be sent to you. Feel free to share with colleagues. The resolution of some slides may be suboptimal due to the webinar software. Those slides will look fine in the presentation that we send you. Briefing recording will be distributed http://support.citrixonline.com/en_US/Webinar W I T H I N 2 4 H O U R S 3 @cbinsights @nikillinit #googlehealth J O I N T H E C O N V E R S A T I O N O N T W I T T E R 4 W H O W E A R E The technology market intelligence platform. CB Insights software lets you predict, discuss, and communicate emerging technology trends using data in ways that are beyond human cognition. 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Beti Cung, Corporate Strategy, Microsoft Invitation-only membership network Membership is strictly by invitation only For leaders driving innovation & growth in their organizations Cross-industry membership of senior leaders from corporate strategy, innovation, venture, M&A, digital strategy and technology Curated peer- level groups Membership is limited to SVPs, EVPs, presidents and C-level executives from companies with $1 billion in revenue or more Access to innovators & big thinkers We augment experience- based insights by bringing in and connecting you with entrepreneurs, venture capitalists, academics and big thinkers who provide front-line perspectives and frameworks you can use to navigate the growth challenges you face About CB Insights Councils 7 Participating Companies 8 May 7-8, 2018 Optimizing Labs, Incubators, Accelerators San Francisco, CA Confirmed Attendees: Chief Strategy Officer at Change Healthcare Executive, Business Innovation at CoreLogic SVP Business Innovation at Konica Minolta Chief Technology Officer at Northwestern Mutual Chief Innovation Officer at USAA SVP and Head of Accelerator at Wells Fargo Next Council Session 9 APPLY FOR COUNCILS MEMBERSHIP EMAIL community@cbinsights.com VISIT www.events.cbinsights.com/councils 11 Nikhil Krishnan A B O U T T H E A N A L Y S T Nikhil Krishnan is a senior analyst at CB Insights, where he produces data- driven analysis and research reports on trends in digital health, ag tech, and construction. He sends the weekly Digital Health Insights newsletter to 30K+ members. His research has been featured in The Economist, New York Times, Wall Street Journal, and more. Prior to joining CB Insights, Nikhil worked at Uber, the Small Business Administration, and Relationship Science. Most popular analyses by Nikhil: Oscar Health Insurance Strategy Teardown Apple In Healthcare @nikillinit | nkrishnan@cbinsights.com Senior Analyst 12 Contents - - - - - Organization structure Google's innovation strategy and advantages in health Google's using AI to combat disease Google Cloud and the healthcare data layer Google's future plans in healthcare 13 G O O G L E I N H E A L T H C A R E Organization structure 14 In 2015, Google restructures as Alphabet. Several subsidiaries are dedicated to healthcare. 15 The healthcare focused divisions Verily is focused on using data to improve healthcare via analytics tools, interventions, research, and more. DeepMind is dedicated to artificial intelligence research. One of its main initiatives is finding ways AI can be applied to healthcare. Arthur Levinson, CEO Andrew Conrad, CEO Calico is focused on learning about the process of aging and age-related diseases. The hope is to find ways to combat this. Demis Hassabis, CEO 16 G O O G L E I N H E A L T H C A R E Google's innovation, strategy, and advantages 17 Google and Verily shift strategies "Only through the truth are we going to defeat Mother Nature." December 7th, 2015 "Mother Nature defeated us wildly." April 19th, 2017 Andrew Conrad, CEO Verily 18 Google is expanding its search for where it can be most useful in healthcare Increased investment and exposure to startups Looking outside of the US for technologies and partners Establishing partnerships with more existing healthcare players 19 "To aid our pursuit of some of healthcare's biggest challenges, Verily recognizes that we need to collaborate with both large, market-leading companies and pioneering start-ups who are working tirelessly to push the boundaries, operating on the edge of technology. With this in mind, we have created Verily Partner Space, a hub for promising young companies and entrepreneurs who join us on our campus in South San Francisco." V E R I L Y L O O K S F O R I N N O V A T I O N V I A E A R L Y S T A G E S T A R T U P S Verily Partner Space S E L E C T L A B C O M P A N I E S 20 GV also increases healthcare startup exposure Number of Google Ventures digital health and healthcare deals, 2013 - 2017 9 8 15 16 27 2013 2014 2015 2016 2017 CB Insights 21 Google is looking outside of the US Verily raises $800M from Temasek Holdings to commercialize and partner internationally Verily invests in European VC + Google invests in Chinese AI drug discovery company Alphabet's Verily Invests In $300 Million EU Biotech Fund June 15th, 2017 22 DeepMind partners with NHS eye hospital to conduct AI research July 5th, 2016 The partnership strategy 23 Google's 3 main advantages E N T E R I N G H E A L T H C A R E AI expertise Cash pile Consumer reach 24 Google's 3 main advantages E N T E R I N G H E A L T H C A R E AI expertise Cash pile Consumer reach 25 Healthcare is becoming a data problem 153 exabytes of healthcare data produced 2013 2,314 exabytes of healthcare data projected 2020 International Data Corporation 26 The data is coming from different places EMR penetration rate wearables sold in 2017 human genomes sequenced IDC, Forbes, CDC 113M 500K+ 86%+ 27 As data begins to define healthcare, Google's expertise in AI is its main advantage. 28 Google is emphasizing it's an AI/ML first company Mentions of "Machine Learning" in earnings transcripts, 2013 - 2017 CB Insights Earnings Call Database Google is focusing on ML/AI Google is emphasizing its machine learning and artificial intelligence capabilities. CEO Sundar Pichai mentioned in a recent earnings call that Google is preparing itself as we move from a "mobile first" world to an "AI first" one. 0 10 20 30 40 50 60 2013 2014 2015 2016 2017 Amazon Apple Facebook Google Microsoft 29 In big tech, Google is the most active investor and acquirer of AI companies. CB Insights 30 "So tomorrow, if AI can shape healthcare, it has to work through the regulations of healthcare In fact, I see that as one of the biggest areas is where the benefits will play out for the next 10 - 20 years." Sundar Pichai, CEO NDTV O P T I M I S M F O R A I I N H E A L T H C A R E 31 Google's 3 main advantages E N T E R I N G H E A L T H C A R E AI expertise Cash pile Consumer reach 32 Google has distribution and consumer relationships Google products with more than 1 billion users 33 NPS Benchmarks People like Google Compared to some of the existing players in the health industry like health insurance, Google has a much higher Net Promoter Score (NPS). 50 12 Google Health Insurance (average) Google's NPS is much higher than that of health incumbents 34 Google's 3 main advantages E N T E R I N G H E A L T H C A R E AI expertise Cash pile Consumer reach 35 Alphabet Earnings Calls Google has cash Google has a steady and growing cash pile and revenue stream outside of healthcare. This means it has the resources to invest in cash-heavy projects, weather regulatory uncertainty, and deal with the longer timelines associated with healthcare. $58.7B $64.4B $73.1B $86.3B $101.9B 2013 2014 2015 2016 2017 Google's cash pile over time Alphabet's end-of-year cash on the balance sheet, 2013 - 2017 36 G O O G L E I N H E A L T H C A R E Google using AI to combat disease 37 The 3 parts of tackling disease A R E A S O F I N T E R E S T Data generation for possible disease indicators Early detection of disease Management or intervention of disease 1 2 3 38 Google is tackling specific diseases E Y E D I S E A S E Data Generation Optos Disease Detection Disease/Lifestyle Management DISEASE PROGRESSIOND I A B E T E S H E A R T D I S E A S E P A R K I N S O N ' S M U L T I P L E S C L E R O S I S Diabetic Retinopathy Research Ocular Mount Dexcom Glucose Monitor Cardiogram Study Onduo + Smart Syringe Monitoring Patent + Study Watch Retina Heart Health Analysis Study Watch Personalized Parkinson's Liftware One Brave Idea Study Watch MS Observational Study Galvani Bioelectronics 39 Google is tackling specific diseases E Y E D I S E A S E Data Generation Optos Disease Detection Disease/Lifestyle Management DISEASE PROGRESSIOND I A B E T E S H E A R T D I S E A S E P A R K I N S O N ' S M U L T I P L E S C L E R O S I S Diabetic Retinopathy Research Ocular Mount Dexcom Glucose Monitor Cardiogram Study Onduo + Smart Syringe Monitoring Patent + Study Watch Retina Heart Health Analysis Study Watch Personalized Parkinson's Liftware One Brave Idea Study Watch MS Observational Study Galvani Bioelectronics 40 Optos provides Google with retinal image data 41 Google is building on its eye disease research "The results show that our algorithm's performance is on-par with that of ophthalmologists." Performance of the algorithm (black curve) and eight ophthalmologists (colored dots) for the presence of referable diabetic retinopathy based on 9,000+ images. Google 42 DeepMind is partnering with Moorfields Eye Hospital to scale eye scan analyses 43 Google has been building implantable eye devices to help with weakening eyesight CB Insights Patent Database 44 Eye interventions have been a consistent focus area for Verily Word frequency in Verily's published patents, 2013 - 2017 CB Insights Patent Database 2013 2014 2015 2016 2017 polymer layer wearable device handheld tool implanted device optical beam analyte sensor magnetic particle flexible substrate eye mountable device lens enclosure eye mountable device electrical contact eye mountable device pathology image plunger head second polymer biological tissue light source handheld tool wearable device first polymer response signal electrical contact magnified pathology mountable device bio compatible layer analyte response sensing device data packet polymer layer compatible layer power supply contact lens enclosure material response signal wearable device bio compatible layer accommodation actuator second layer measurement period response signal compatible layer assistive device magnetic nanoparticles ophthalmic device hydrophilic copolymer target tissue magnetic field first layer target person 45 Verily is partnering with Novartis/Alcon, but project status is unclear Autofocus contact lens being developed by Verily and Alcon suffers delay November 18th, 2016 46 Google is tackling specific diseases E Y E D I S E A S E Data Generation Optos Disease Detection Disease/Lifestyle Management DISEASE PROGRESSIOND I A B E T E S H E A R T D I S E A S E P A R K I N S O N ' S M U L T I P L E S C L E R O S I S Diabetic Retinopathy Research Ocular Mount Dexcom Glucose Monitor Cardiogram Study Onduo + Smart Syringe Monitoring Patent + Study Watch Retina Heart Health Analysis Study Watch Personalized Parkinson's Liftware One Brave Idea Study Watch MS Observational Study Galvani Bioelectronics 47 Glucose monitoring is one of Google's earliest medical device projects + it's doubling down CB Insights Trends Tool CLICK HERE TO RUN THIS SEARCH IN PLATFORM 48 The fasting tear glucose level did not appear to be a satisfactory index for classifying a person as a diabetic or normal. It was found that after the peroral glucose load test a tear glucose level at 11 mg/100 ml (0.61 mmol/l) resulted in only 4.6% of the diabetics being missed, while 5.8% of the normal persons were misclassified as diabetics. British Journal Of Opthamology C A N T E A R S B E U S E D ? T B D 49 Verily is looking at other ways to capture glucose data Slide from Dexcom investor presentation 50 Verily partnership is increasingly mentioned Mentions of "Verily" in Dexcom earnings calls, 2013 - 2017 CB Insights Earnings Transcripts Tool CLICK HERE TO RUN THIS SEARCH IN PLATFORM 51 Improved glucose monitoring enables Verily's diabetes management program Onduo 52 " just last week, Onduo, a joint venture between Verily and Sanofi, began a limited commercial launch of its diabetes management platform." O N D U O B E G I N S R O L L O U T Sundar Pichai, CEO CB Insights Earnings Call Data February 2, 2018 53 Google looking to new tools? Patent: Smart Syringe Possible expansion into Type 1 diabetes? Patent "Over time, the company plans to expand its focus to include the Type 1 diabetes community, and eventually to people at risk of developing diabetes with the goal of helping them better prevent the onset of the disease." Onduo website Select Companies: 54 A new N=14,011 study shows heart rate sensors you're wearing already like the Apple Watch, Android Wear, Garmin, or Fitbits can detect early signs of diabetes. Researchers at Cardiogram and UCSF validated the accuracy of DeepHeart, a deep neural network, in distinguishing between people with and without diabetes, achieving 85% accuracy on a large data set which included 200 million heart rate and step count measurements. T H E G A P : D I A B E T E S D E T E C T I O N Cardiogram Study: Ordinary wearables can flag signs of diabetes, according to new Cardiogram study 55 Google is tackling specific diseases E Y E D I S E A S E Data Generation Optos Disease Detection Disease/Lifestyle Management DISEASE PROGRESSIOND I A B E T E S H E A R T D I S E A S E P A R K I N S O N ' S M U L T I P L E S C L E R O S I S Diabetic Retinopathy Research Ocular Mount Dexcom Glucose Monitor Cardiogram Study Onduo + Smart Syringe Monitoring Patent + Study Watch Retina Heart Health Analysis Study Watch Personalized Parkinson's Liftware One Brave Idea Study Watch MS Observational Study Galvani Bioelectronics 56 Verily's Study Watch is an enabling tool for many different kinds of research Able to capture data from ECGs, heart rate, electrodermal activity, movement, and more Large internal storage and processor baked in Can do over-the-air software updates 57 Google also patents passive heart monitor and stroke detection via everyday objects CB Insights Patent Database 58 Verily publishes paper looking at cardiovascular risks via retinas using machine learning Nature 59 Verily's "One Brave Idea" issues a $75M grant to better understand heart disease management 60 Google is tackling specific diseases E Y E D I S E A S E Data Generation Optos Disease Detection Disease/Lifestyle Management DISEASE PROGRESSIOND I A B E T E S H E A R T D I S E A S E P A R K I N S O N ' S M U L T I P L E S C L E R O S I S Diabetic Retinopathy Research Ocular Mount Dexcom Glucose Monitor Cardiogram Study Onduo + Smart Syringe Monitoring Patent + Study Watch Retina Heart Health Analysis Study Watch Personalized Parkinson's Liftware One Brave Idea Study Watch MS Observational Study Galvani Bioelectronics 61 Personalized Parkinson's aims to track everything about people with the disease Technology Review Data captured from the Study Watch as well as blood tests and brain scans Partnering with researchers and universities in the Netherlands, follows 650 volunteers Verily is contributing $13M to the study 62 [Bastiaan Bloem, a neurologist who directs the Parkinson Center at Radboud University Medical Center] says all the data will be freely available, but "Verily will have a crack at the data to build algorithms." Bloem expects the data will permit classification of Parkinson's patients into sub-types who might benefit from different treatments. "We hope to get fine-grained phenotype people like you, a 50-year-old man with red hair, will have this or that outcome, but only if you exercise," he says. T H E G O A L : B U I L D A L G O R I T H M S O N T O P O F T H E D A T A Technology Review 63 As Google learns more about the disease, it's currently moving towards helping management of those afflicted. 64 65 Google is tackling specific diseases E Y E D I S E A S E Data Generation Optos Disease Detection Disease/Lifestyle Management DISEASE PROGRESSIOND I A B E T E S H E A R T D I S E A S E P A R K I N S O N ' S M U L T I P L E S C L E R O S I S Diabetic Retinopathy Research Ocular Mount Dexcom Glucose Monitor Cardiogram Study Onduo + Smart Syringe Monitoring Patent + Study Watch Retina Heart Health Analysis Study Watch Personalized Parkinson's Liftware One Brave Idea Study Watch MS Observational Study Galvani Bioelectronics 66 MS Observational Study builds on existing Brigham and Women's Hospital research Brigham and Women's Hospital The collaboration builds on existing research Comprehensive Longitudinal Investigation of MS (CLIMB), which tracks 2,000+ patients Study Watch captures data on gait, mobility, dexterity, and more. Verily will help with machine learning expertise to bring datasets together and generate insights. 67 Bioelectronics as a possible intervention? Verily is working with GSK to develop miniature electronics to control how electrical signals flow throughout the body. This could be used to assist MS patients with their gait, or even be used in halting the disease as we learn how it progresses. 68 Using a mouse model of [multiple sclerosis], experimental autoimmune encephalomyelitis, we show that autoreactive T cells access the central nervous system via the fifth lumbar spinal cord Impairing soleus muscle contraction by tail suspension is sufficient to reduce localized chemokine expression and block entry of pathogenic T cells at the fifth lumbar cord, suggesting that regional neuroimmune interactions may offer therapeutic targets for a variety of neurological diseases. L O O K I N G F O R A N M S C U R E Cell Preliminary studies suggest stimulation of certain areas can stop MS progression in rats 69 ReWalk Robotics builds soft exoskeletons to help people recover from strokes and neurological disorders Select Investors ProSeed Venture Capital, SCP Vitalife, YASAKAWA Electric C O U L D G O O G L E P A R T N E R W I T H O R A C Q U I R E E X O S K E L E T O N C O M P A N I E S T O A I D M O B I L I T Y I M P A I R E D M S P A T I E N T S ? Funding $11.4M (Public) S I M I L A R C O M P A N I E S 70 G O O G L E I N H E A L T H C A R E Google Cloud and the healthcare data layer 71 Interoperability and data access are huge problems in healthcare ClearDATA 14% Of surveyed doctors said they could access EHR information across care settings 79% Of survey doctors said comprehensive access to full patient records was extremely critical 72 Google wants to create the new data infrastructure in healthcare for people to build on. 73 Google has learned from its mistakes In 2008 Google started a personal health record initiative called Google Health, which shut down in 2011. Google is now plugging into the healthcare infrastructure by working with providers, researchers, and existing health institutions. 74 How Google is integrating into the health data infrastructure Creating pipes within health giants Pushing Google-Cloud- enabled services Building its own datasets for third parties to build on 1 2 3 75 How Google is integrating into the health data infrastructure Creating pipes within health giants Pushing Google Cloud enabled services Building its own datasets for third parties to build on top of 1 2 3 76 Google is building data pipes with a new health data standard called FHIR Fast Healthcare Interoperability Resources (FHIR) developed under the non-profit HL7 organization Uses a similar data sending and retrieval mechanism to web standards (e.g. discrete taggable data elements instead of full documents, JSON/XML formats, etc.) Can be used to build application programming interfaces (APIs) to port data from places 77 DeepMind is plugging into patient records using FHIR to power a third-party app ecosystem TechCrunch 78 DeepMind is building its own apps, too DeepMind is building its own apps. Streams, for example, is a tool for nurses and clinicians to detect acute kidney injury earlier. 79 Apigee lets institution build their own APIs and apps Google acquired Apigee for $625M, which included an API management software that uses FHIR to enable interoperability. Apigee is one of the services offered through the Google Cloud suite. 80 How Google is integrating into the health data infrastructure Creating pipes within health giants Pushing Google-Cloud- enabled services Building its own datasets for third parties to build on top of 1 2 3 81 Google is pushing their cloud platform Mentions of "cloud" in Alphabet's earnings calls, 2013 - 2017 CB Insights Earnings Transcripts Tool 82 Google offers G Suite for healthcare practitioners built on top of its cloud offering TechCrunch 83 Google Blog Open-source tools for research Google is rolling out open- source tools for researchers, such as DeepVariant for genomic analysis. DeepVariant also demonstrates one other advantage Google has in the space: it can test its products with Verily, its in-house life sciences team which helped in releasing the software. 84 "One of the things that we've done is one of my scientists has worked to create a yeast tracker that allows us to figure out how old each yeast cell is it's computer vision." Daphne Koller Former Chief Computing Officer, Calico CB Insights A-ha! Conference M O R E T O O L S T O C O M E ? 85 As more health institutions use Google Cloud services, it becomes part of the infrastructure Glintech 86 How Google is integrating into the health data infrastructure Creating pipes within health giants Pushing Google Cloud enabled services Building its own datasets for third parties to build on 1 2 3 87 Google is building datasets for people to build on as well 88 Project Baseline is tracking 10,000 voluntary participants over 4 years 89 "By signing this consent, you are allowing the Baseline Team to keep all of the information you provide in a database, called the Baseline Database In the future, the Baseline Team may allow the data to be used by researchers outside of the Baseline Team. If this happens, the Baseline Team will not include direct identifiers (name, street address, phone number, and email address)." Baseline's Informed Consent suggests the dataset will be used for other researchers to access and build on 90 G O O G L E I N H E A L T H C A R E Google's future plans in healthcare 91 The next diseases to tackle? C O P D Data Generation Study Watch Disease Detection Disease/Lifestyle Management DISEASE PROGRSESIONC A N C E R M E N T A L + B E H A V I O R A L H E A L T H Senosis Health Galvani Biolelectronics (?) Freenome + MRI/CT images Tumor detection research Radiotherapy planning + peer support Search data Quartet Health A G I N G Calico (new drugs + lifestyle changes) Mobile based intervention and therapy Calico (aging process) Calico (data from mice) 92 Chronic Obstructive Pulmonary Disease Senosis acquisition Galvani Electroceuticals use case? Source: GlaxoSmithKline 93 Cancer (various forms) Freenome investment Tumor identification research Head and neck cancer radiotherapy planning + peer to peer support Gap: Data stream from MRI and CT scans Google, Clinicaltrials.gov 94 Mental and behavioral health National Alliance on Mental Illness partnership Quartet Health investment Gap: Therapy or coaching for people diagnosed with mental or behavioral illness 95 Aging Studying other animal and biological systems to understand aging process New drugs and interventions Google's Calico partners with new biotech firm to develop anti-aging and cancer drugs March 24th, 2017 Calico, VentureBeat 96 Google moving into tools for doctors In conjunction with Johnson & Johnson, Verily is working on creating robots for surgeries. Some patents filed include ways to use existing images and lighting to partially or fully automatically conduct surgeries. Google patented a combination of a pressure cuff, camera, and machine vision to help doctors conduct an abdominojugular reflux test, which requires a high level of precision and has a large variance in how it's conducted by different doctors. CB Insights Patent Database 97 Diagnostics for patients next? Google's Pixel phone could be used for new diagnostic and screening capabilities, similar to the iPhone + ResearchKit. Google has a patent for a concussion test via a type of headset. Google could build new hardware with diagnostic capabilities, including a consumer version of the Study Watch. CB Insights Patent Database The Google Home could be used to help screen for certain diseases via Q&A, or help with adherence and lifestyle management of disease. 98 Google + population health interventions Debug aims to engineer and release sterile mosquitoes into the population in order to eliminate disease carrying mosquitoes. Future population health interventions could see use of autonomous cars from Waymo for in-car health monitoring or find other uses for look at other areas to use machine vision, such as livestock disease outbreak. Spinout Cityblock aims to support Medicaid and Medicare patients by understanding data about their environments and social determinants to provide personalized care. 99 Taking on the risk: Google Insurance Verily 100 Will people trust Google? Survey of registered voters: "How Much Do You Trust Google To Keep Your Personal Data Private?" Morning Consult + Politico National Tracking Poll 53% Not At All/ Not Very Much 39% A Great Deal/ A Fair Amount 8% Don't Know/ No Opinion 101 Questions? Twitter: @nikillinit nkrishnan@cbinsights.com 102 The CB Insights platform has the underlying data included in this report W H E R E I S A L L T H I S D A T A F R O M ? CLICK HERE TO SIGN UP FOR FREE 103 cbinsights.com @cbinsights Nikhil Krishnan nkrishnan@cbinsights.com

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How the tech giant is attacking the healthcare space

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