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Friday, February 3, 2023

Meet the Scientists Who Want to Make Medical Devices Work for Everyone, Finally

 

FEB. 2, 2023

MEET THE SCIENTISTS WHO WANT TO MAKE MEDICAL DEVICES WORK FOR EVERYONE, FINALLY

In the early months of the pandemic, Ashraf Fawzy, then a pulmonary fellow at Johns Hopkins University, noticed something strange. Black patients he was treating, all hospitalized with Covid-19, had oxygen levels scattered all over the place, often not in sync with their dire respiratory symptoms.

“I remember one particular encounter…an African American woman, relatively young with asthma, came in with Covid [and] we were weaning her off supplemental oxygen,” Fawzy, now an assistant professor of medicine at Johns Hopkins, tells Inverse. But the patient’s pulse oximeter — a non-invasive medical device to rapidly measure blood oxygen levels — were giving readings higher than what her actual oxygen levels were on blood tests.

“We realized we were under-treating her with oxygen because we were relying on these inaccurate pulse oximeters,” he says.

One inaccurate machine could have been an isolated case, but Fawzy wasn’t the only one noticing something off with pulse oximeters. As the Covid-19 pandemic raged on and the simple fingertip device became an increasingly recommended way to monitor drops in oxygen, a December 2020 study in the New England Journal of Medicine captured national attention: Black patients were nearly three times more likely than white patients to have hidden hypoxemia, or dangerously low oxygen levels missed entirely by pulse oximeters.

"WE REALIZED WE WERE UNDER-TREATING HER WITH OXYGEN BECAUSE WE WERE RELYING ON THESE INACCURATE PULSE OXIMETERS."

The study spurred considerable alarm within the medical community, as pulse oximeters are a heavily relied-on medical device. In 2021, patients and lawmakers sent a letter to the Food and Drug Administration (FDA) expressing concerns about potential racial disparities, noting the pulse oximeter disparity as “a matter of life or death.”

“The pulse [oximeter] has become the poster child of [health inequity], in part because of the pandemic. It really highlights the need for diversity at all stages of technology development, from the nascent stages of coming up with a design to how these things are tested, vetted, and distributed,” Kimani Toussaint, a professor of engineering at Brown University, tells Inverse.

Pulse oximeters are just one example of a persistent, prevalent, and overlooked problem that the Covid-19 pandemic brought to light: Medicine and healthcare have harbored racial bias since their inception. But this long-known problem finally reached the federal level. In November 2022, the FDA discussed plans to both improve pulse oximeter regulation and provide clearer labeling and more testing of these devices. Now, the question becomes, can scientists fix these biases, starting with the ubiquitous pulse oximeter, and prevent them from happening in the future?

THE HISTORY OF THE PULSE OXIMETER

Long before it made its way to hospitals and consumer markets, the pulse oximeter was originally developed for the military by American and German scientists during World War II, according to a 1986 article in the Journal of Clinical Monitoring. The aim was to prevent fighter pilots from losing consciousness due to oxygen deprivation as they flew at high altitudes. The first iteration of the device, according to the report, was more of a clip-on earring pilots wore that warned them to take supplemental oxygen when their oxygen levels dipped below a critical level, making them more likely to lose consciousness.

PULSE OXIMETERS ARE JUST ONE EXAMPLE OF A PERSISTENT, PREVALENT, AND OVERLOOKED PROBLEM THAT THE COVID-19 PANDEMIC BROUGHT TO LIGHT: MEDICINE AND HEALTHCARE HAVE HARBORED RACIAL BIAS SINCE THEIR INCEPTION.

Between the 1960s and 1970s, while collaborating with NASA to develop health devices for astronauts, computer company Hewlett-Packard (HP) took a stab at expanding the ear pulse oximeter for the hospital market.

Interestingly enough, this would be the first attempt at an equitable device, although this probably wasn’t purely for the sake of equity.

At the time, and still today, pulse oximeters worked like this: A light source shines two wavelengths of light — red light at 600 nanometers and infrared light at 940 nanometers — into a finger, passing through fingernail, skin, tissue, and blood. Hemoglobin, the molecule that carries oxygen throughout the body, absorbs either wavelength depending on whether it’s oxygenated (absorbing more infrared light) or not (absorbing more red light). How much of either wavelength is relayed back to the pulse oximetry is used to provide a blood oxygen level percentage.

HP said it wanted something that would work for all skin types; in the October 1976 issue of their journal, called The Hewlett-Packard Journal, the company acknowledged how oxygen level readings were impacted by “skin and blood pigments, and the surface characteristics of the skin.” HP engineers borrowed the ear clip-on design and wired it with fiber optic cables that transmitted eight different wavelengths of light onto the skin — different brightness settings for different skin types. This build allowed the oxygen reader to be specifically adjusted and calibrated to one’s skin color. Indeed, this appeared to work in experimental trials HP conducted involving Black patients. Later studies of HP’s device show that this early pulse oximeter more closely matched the invasive arterial blood gas tests, which takes a blood sample to measure oxygen levels along with carbon dioxide and pH.

Despite its early promise, HP’s pulse oximeter didn’t take off and had quite a number of limitations, Philip Bickler, director of the University of California, San Francisco’s Hypoxia Lab, tells Inverse.

“It was a clumsy clamp that you put on the ears that didn’t really account for differences in the size and shape of [someone’s] ears,” says Bickler.

On top of that, it was quite pricey at $13,000 a pop in 1970 and found mostly in a select few research labs. With the boom of the personal computing market of the 1980s, HP shifted its focus and abandoned plans to miniaturize its pulse oximeter.

LAYERS ON LAYERS OF BIAS

Subsequent devices would continue to use light as a means of measuring oxygen levels. Given how versatile light is with its spectrum of wavelengths and intensities, it wouldn’t have been hard for pulse oximeter manufacturers to calibrate their devices for darker skin tones, as HP had done. But at the time, the nascent market was largely dominated by those of lighter skin, such as in Europe, the U.S., and Japan, says Bickler. The bias persisted simply because differences in skin color weren’t considered at all important.

“Any additional complexity [like skin color] was met with resistance and a lack of interest,” says Bickler, who in 2005 co-authored one of several other early studies investigating how skin color affected pulse oximeter readings. “[Our study] was largely ignored. It was inconvenient for pulse oximeter manufacturers to accept that the way they had been testing and calibrating their devices [with lighter skin tones] had a flaw.”

The indifference speaks to a wider, persisting crisis of bias within medicine, health care, and pharmaceutical or medical device development, Achuta Kadambi, an engineering professor at the University of California, Los Angeles, tells Inverse.

“There’s essentially three types of bias: The bias of the physical layer, which is what we’re talking about often with pulse oximeters,” he says. “Then there’s bias at the [artificial intelligence], or computational, layer, and a third layer is interpretation bias, which means that even if the rest of the system is equitable, you might have a human factor adjust the output accordingly.”

A prime example of interpretation bias, says Kadambi, is pulmonary function testing, where the results are filtered through equations that compare, or correct, the data against healthy values based on sex, height, age, as well as race. For Blacks and other ethnic minorities, these adjustments tend to assume a lower lung function. That doesn’t necessarily reflect on someone’s actual innate biology. Instead, it normalizes disparities that lead to poor lung health and exacerbate chronic disease, as studies have found.

THE BIAS EXTENDS EVEN BEYOND WHAT’S TYPICALLY USED IN A CLINICAL SETTING TO OUR EVERYDAY WEARABLES RELAYING A CONSTANT STREAM OF DATA WE USE TO MONITOR AND GUIDE OUR OWN HEALTH.

Other medical-grade devices harboring bias include the ubiquitous infrared thermometers, which are as much relied upon as pulse oximeters to make clinical decisions. A 2022 study out of Emory University found these forehead thermometers, which infer body temperature through infrared radiation produced by the body, were as much as 26 percent less accurate at detecting fever in Black patients compared to oral thermometers.

The bias extends even beyond what’s typically used in a clinical setting to our everyday wearables relaying a constant stream of data we use to monitor and guide our own health.

Devices like Fitbits and Apple Watches operate in a similar fashion to pulse oximeters, using light sensors to capture information such as oxygen levels and heart rate. Most of these wearables use green light (a cheaper option than red and infrared light used in a hospital-grade device), which a number of studies over the years have found may give inaccurate results for those of darker skin and people with obesity. This bias hasn’t gone unnoticed, judging from online complaints and the fact that last month, Apple was hit with a class-action lawsuit for allegedly not warning consumers that its Watch couldn’t accurately gauge blood oxygen levels for those of darker skin.

In the case of pulse oximeters, subsequent studies since the December 2020 report in the New England Journal of Medicine have found inaccurate pulse oximeters readings delayed timely Covid-19 treatments for patients with darker skin or not getting appropriate treatment at all, according to Fawzy, in a study he co-authored in 2022, which was published in JAMA. (Important to note pulse oximeters are not solely to blame for the high Covid-19 mortality rate in Black and other ethnic minorities.) And this is problematic not just for anyone of darker skin hospitalized with Covid-19 but for anyone of darker skin with respiratory issues managed by pulse oximeters.

“As a pulmonologist, my main research interest is COPD [chronic obstructive pulmonary disease], and in COPD, we prescribe oxygen to patients based on their pulse oximeter readings,” says Fawzy. “We’ve been depending on [pulse oximeters] to say whether someone has sleep apnea for decades. So it’s really problematic that there’s a potential underdiagnosis in lung diseases for prescribing oxygen [and] a potential for under-diagnosing sleep apnea using these devices.”

WHAT’S THE SOLUTION?

In February 2021, the FDA issued a warning that skin pigmentation and other factors could impact pulse oximeter readings. And this past November, a Medical Devices Advisory committee convened to review the current clinical data on pulse oximeters, recommending the agency update its regulation and put labels that warn of potentially inaccurate readings. The FDA has requested new studies to assess pulse oximeter accuracy in hospital settings for both adults and children.

For Black engineers like Valencia Koomson, an associate professor of electrical and computer engineering at Tufts University, the challenge to offsetting the racial bias is not so much overhauling the pulse oximeter entirely but finding ways to improve how it functions.

“We’re dealing with very weak optical signals that have to transverse through tissues with lots of [other] elements that absorb and scatter light,” she tells Inverse. “It’s very similar to when you’re riding a car, and you go through a tunnel. You lose signal because of the absorption of the materials in the tunnel, such that the signal being transmitted from the cell phone tower is too weak to be processed by your phone.

To remedy this, Koomson and her fellow scientists are working on a pulse oximeter that uses the same light as devices currently on the market but includes a technology that measures a person’s skin tone. So if you’ve got darker skin (i.e., more melanin), the pulse oximeter will emit more light.

Skin color, though, isn’t the factor that can give rise to inaccurate pulse oximeter readings. At the Hypoxia Lab, Bickler and his colleagues are seeking to comprehensively understand how these other factors like blood flow and body temperature stacked on top of skin color impact a pulse oximeter reading. In a recent study that’s currently in pre-print, the researchers found that poor perfusion, or blood flow through vessels and body tissues, exacerbated inaccurate pulse oximeter oxygen readings alongside skin color.

“Poor perfusion is super common in sick people,” says Bickler, due to a combination of problems such as low blood oxygen levels, being dehydrated, or being on medications that cause blood vessels to constrict.

Koomson says while further research and innovation are all great and good, it doesn’t change the fact that devising with equity in mind needs to happen at the federal regulatory level, with how the FDA sets guidelines for pulse oximetry approval, which on the whole are relatively lax.

“We know that if you have a [federal] guideline that says that a device has to be tested on a minimum of 10 people and at least 15 percent have to be [of] dark skin pigmentation, that opens the door for a lot of loopholes because ‘dark’ is very subjective,” says Koomson. “That subjectivity is going to affect the kind of product that you put out.”

Other Black engineers, like Brown’s Kimani Toussaint, are taking a slightly offbeat tack by investigating how light’s electromagnetic waves interact and behave with matter such as body tissues, the skin pigment melanin, and blood.

“We’re trying to exploit [these] properties to see if we can use that to differentiate between the response from oxygenated hemoglobin versus deoxygenated hemoglobin,” says Toussaint. “Although we strive to get rid of the bias completely, it’s still an open question how effective our approach is… and how reduced is the effect of having the melanin contribution.”

Toussaint’s lab also has a prototype that’s undergone some initial trials in healthy volunteers. An upcoming clinical study started earlier this year at the intensive care unit at The Miriam Hospital in Providence, Rhode Island. “We’re trying to vet this [device] right now, compare it to [the] gold standard arterial blood draw that physicians normally use,” he says.

Bickler, Fawzy, and Toussaint are optimistic that shining a spotlight on the pulse oximeter will be the clarion call to action within the health community, rousing physicians and other healthcare workers to advocate for a better understanding of the inequities inherent in this devices as well as a hunt for solutions — especially as we don’t have more equitable, non-invasive technologies or alternatives on the foreseeable horizon.

“The FDA is working very hard towards improving [pulse oximeters]. We’ve had funding from the FDA to study pulse oximeters in patients in the hospital and in real-world clinic conditions in a very carefully controlled way,” says Bickler. “It’s been almost 20 years since this was really defined as a problem, and here we are 20 years later. Yes, it’s way too late, but at least it’s on the radar.”

It may also encourage discourse around bias beyond the borders of the pulse oximeter, firmly entrenched in other medical devices and in health care at large.

Part of that need for diversity is essential within a workforce that can inform and guide equity during a technology’s development. According to a 2021 Pew Research Center study, while jobs in science, technology, engineering, and math (STEM) have seen considerable growth in years, Black and Hispanic workers still remain underrepresented.

“These are things now where we have to think about how technologies aren’t as agnostic as we may have thought in terms of their impact on communities,” says Toussaint, “It’s part of the human condition to think about how bias can creep in and be perpetuated, whether deliberately or not.”

This has been HORIZONS, a newsletter that explores the innovations of today shaping the world of tomorrow.

Do you think it can be improved? Have a story idea? Send your tips and all other musings to horizons@inverse.com

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Tuesday, December 6, 2022

Digital.Health

 I have been exploring the recently launched Digital.Health repository. It is an exceptional digital health resource. https://digital.health/


Friday, November 15, 2019

eHealth news, feeds, business and intelligence sources

There is a lot of information about ehealth and health informatics. I am not talking specifically about academic research journals - that is a whole other sort of information. Sometimes it is difficult to sort out information about healthcare in general from information that is specific to ehealth, as both are so intertwined. I have been following ehealth news sources for over a decade. My inner ehealth journalist would feed on these sources for material - as would a blogger.

Here are "some" of the main sources of information that I have been receiving:

1. Blogs
2. Healthcare Technology Newsletters
3. Health Informatics Association Newsletters
4. Twitter and Facebook
5. Google News
6. Journal subscriptions
7. Business Intelligence

Blogs
Healthcare Technology Newsletters

Health Informatics Association Newsletters
Twitter and Facebook
Business Intelligence
Google News
  • Set a search criteria on "Health Informatics" in favourites



Thursday, November 14, 2019

CB Insights - Digital Health 150: The Digital Health Startups Redefining The Healthcare Industry

I have been trying to follow all the news from CB Insights: Technology Market Intelligence. They have extremely rich information on digital health. Here is a sample or intro:
https://www.cbinsights.com/research/

The most promising 150 private digital health startups working to transform the healthcare industry with new models of primary care to emerging tech solutions for providers.

CB Insights’ first ever annual cohort of Digital Health 150 startups is a list of 150 of the most promising private companies creating innovative products and services in the $5T+ healthcare industry, according to CB Insights’ Industry Analyst Consensus.
Our research team selected the 150 startups from a pool of 5K+ companies based on several factors, including patent activity, investor profile, news sentiment analysis, proprietary Mosaic scores, market potential, partnerships, competitive landscape, team strength, and tech novelty.
For the purposes of this report, digital health is defined as companies in the healthcare space that use technology/software as a key differentiator from their competition. This includes everything from disease diagnostics to tech-driven health insurance platforms to AI tools for drug discovery, and more.
Startups are categorized by their main focus areas. Categories in the market map below are not mutually exclusive.
Please click to enlarge.

Table of contents

150 startups in different stages of R&D

The Digital Health 150 companies span a wide spectrum of categories that involve all three key stakeholder groups for the healthcare industry — providers, payers, and patients.
These companies range from emerging startups to established unicorns (companies with $1B+ valuations). The selected companies represent a mix of startups at different stages of funding and product commercialization.

For example, China-based We Doctor has a valuation of $5.5B and provides primary care services that leverage its tech platforms and provider network.
In contrast, RDMD is an early-stage company specializing in drug discovery efforts for rare diseases. The company plans to aggregate data to help develop treatments for a range of conditions.
A total of 17 companies on the list are unicorns (private companies valued at $1B+). Of these, 12 companies are US-based, 3 are based in China, 1 is based in France, and 1 is based in the UK.
2019 Digital Health 150 Unicorn Startups
Company Category Country
We Doctor Providers: Primary Care China
GRAIL Genomics United States
Oscar Health Insurance & Benefits United States
Tempus Drug R&D: Real-World Evidence United States
GoodRx Pharma Supply Chain United States
23andMe Genomics United States
Babylon Health Providers: Primary Care (Virtual-Only) United Kingdom
Devoted Health Insurance & Benefits United States
HeartFlow Diagnostics: Imaging United States
Proteus Digital Health Digital Therapeutics United States
Butterfly Network Diagnostics: Imaging United States
Doctolib Providers: Primary Care (Virtual-Only) France
Hims Pharma Supply Chain United States
Calm Consumer Health & Wellness United States
LinkDoc Technology Drug R&D: Clinical Trials China
One Medical Group Providers: Primary Care United States
Tencent Trusted Doctors Providers: Primary Care China

Most well-funded companies

The most well-funded companies on the Digital Health 150 list span a broad range of categories. The top-funded company is genomics startup GRAIL, followed by insurance tech player Oscar Health and then China-based We Doctor.

Startups outside the United States

Of the 150 selected digital health startups, 116 are headquartered in the US. Those based outside the US include 17 from Asia, 16 from Europe, and 1 from Canada.

After the US, China is the second most-represented country on this list, with 7 of the selected companies, and Israel is third with 4 companies.

Most active investors

Over 850 unique investors have funded this year’s Digital Health 150 cohort, including corporations, CVCs, VC firms, and angel investors.
Below, we highlight the top 10 most active investors among the companies selected.
Investor Number of deals
F-Prime Capital 31
New Enterprise Associates 30
Google Ventures 29
Venrock 28
Founders Fund 27
Khosla Ventures 27
GE Ventures 22
Social Capital 20
.406 Ventures 19
Andreessen Horowitz 18

Track all the Digital Health 150 Startups in this brief and many more on our platform

The 150 private digital health startups working to recreate how healthcare is delivered. Look for The Digital Health 150 in the Collections tab.
Collections is the first collaborative work management solution purpose-built for corporate growth teams responsible for managing build, buy, or partner decisions.

Themes & trends

Across our 150 selected companies, we identified key themes and trends that highlight their efforts to transform the healthcare industry.
Below, we discuss a selection of these trends across different categories.

Artificial intelligence

Many companies on our list are leveraging AI and machine learning to help develop their respective software platforms.
From consumer health companies to imaging & diagnostics startups, AI is at the forefront of their products and services.
One example here is pathology — an area that AI has begun to transform. For instance, startups such as PathAI and PAIGE.AI are using AI to help speed up patient diagnosis.

Source: PAIGE.AI
AI is also being leveraged through drug discovery & development — accelerating the identification of new targets and therapeutic candidates.
An example here is OWKIN, a startup that develops algorithms to help interpret disease-related data and predict treatment outcomes.

Women’s health

As investments to women’s health startups have increased, we’ve seen startups targeting everything from egg freezing services to emerging tech for managing menopause.
In particular, fertility has gained traction as one of the main area of interest for women.
Startups such as Ava Science (fertility tracking device) and Carrot Fertility (fertility supplemental insurance) are providing novel services that aim to boost accessibility and convenience.
Virtual care clinics such as Maven Clinic are also helping women gain better access to providers that cater specifically to women’s health needs and concerns.

Source: Maven Clinic
Maven raised a $27M Series B round in September 2018 with participating investors including Sequoia Capital and Oak HC/FT Partners, among others.

Senior care

The growing size of the aging population is creating an increased demand for tech that aims to improve their health management.
This includes services targeted at both home care solutions and care coordination between providers.
One example here is ClearCare — a home care platform that aims to facilitate everything from administrative tasks to tracking patient hospitalizations.

Source: ClearCare

Social determinants of health

Population health has been generating a lot of buzz in healthcare. In particular, there’s a growing emphasis on leveraging social determinants of health (SDoH) to generate better health outcomes.
An example here is Unite Us, a New York-based startup working to build care networks that integrate SDoH into how healthcare is delivered.

Source: Unite Us
Its approach is to provide care coordination software that can handle external referrals and track patient outcomes, helping to connect healthcare with social services.

Value-based care

As more healthcare stakeholders look to collaboration to spur innovation in the industry, value-based care has come to the forefront.
In particular, payers and providers have established new care coordination networks to help reduce overall healthcare costs — with the goal of delivering care that provides better value to patients.
An example here is Vim, which provides patients with access to both payers and providers to make it easier to find appropriate care options.

Source: Vim
Vim raised a $24M Series B round in September, with participating investors including Optum Ventures, Premera Blue Cross, and Sequoia Capital, among others.

Concierge medicine

Concierge medicine startups, such as One Medical or Parsley Health, use a membership model to help offer patients an elevated healthcare services experience.
The approach aims to offer faster health visits with providers and more predictable associated costs.

Source: Galileo Health
Recently, Galileo Health — started by the founder of One Medical — launched an app-based concierge medicine platform geared towards providing a comprehensive level of care, including for chronic disease management.
It raised funding from Oak HC/FT Partners in May.

Telehealth

Telehealth services have expanded in recent years to become more differentiated.
Primary care platforms such as Ada Health and 98point6 are helping patients access more tailored care from their smartphones.
For instance, 98point6 offers a subscription on-demand telemedicine platform — touting 24/7 access to board-certified physicians — that’s delivered via a mobile app.

Source: 98point6
The startup raised a $50M Series C in October 2018 from Goldman Sachs and Frazier Healthcare Partners.
Another example is Talkspace, which offers psychotherapy services delivered virtually. It has raised $109M in total disclosed funding from investors including Compound, Norwest Venture Partners, Spark Capital, and SoftBank, among others.
Other companies in this category use remote monitoring technology to supplement virtual care services.

Table of the Digital Health 150 companies

2019 Digital Health 150 Companies
Company Category
Ava Science Consumer Health & Wellness
Calm Consumer Health & Wellness
CarePredict Consumer Health & Wellness
Ciitizen Consumer Health & Wellness
Dreem Consumer Health & Wellness
Headspace Consumer Health & Wellness
higi Consumer Health & Wellness
Oura Health Consumer Health & Wellness
TytoCare Consumer Health & Wellness
Aidoc Medical Diagnostics: Imaging
Arterys Diagnostics: Imaging
Butterfly Network Diagnostics: Imaging
eXo Imaging Diagnostics: Imaging
HeartFlow Diagnostics: Imaging
icometrix Diagnostics: Imaging
IDx Diagnostics: Imaging
Lifetrack Medical Systems Diagnostics: Imaging
Lunit Diagnostics: Imaging
Niramai Diagnostics: Imaging
Viz.ai Diagnostics: Imaging
VoxelCloud Diagnostics: Imaging
Zebra Medical Vision Diagnostics: Imaging
Athelas Diagnostics: Other Diagnostics
Cue Health Diagnostics: Other Diagnostics
Healthy.io Diagnostics: Other Diagnostics
Letsgetchecked Diagnostics: Other Diagnostics
Deep Lens Diagnostics: Pathology
PAIGE.AI Diagnostics: Pathology
PathAI Diagnostics: Pathology
Proscia Diagnostics: Pathology
Akili Interactive Labs Digital Therapeutics
Biofourmis Digital Therapeutics
Cara Care Digital Therapeutics
Click Therapeutics Digital Therapeutics
CureApp Digital Therapeutics
Glooko Digital Therapeutics
Kaia Health Digital Therapeutics
Lark Health Digital Therapeutics
Neurotrack Technologies Digital Therapeutics
Noom Digital Therapeutics
Omada Health Digital Therapeutics
Pear Therapeutics Digital Therapeutics
Pivot Digital Therapeutics
Proteus Digital Health Digital Therapeutics
SWORD Health Digital Therapeutics
Vida Health Digital Therapeutics
Virta Health Digital Therapeutics
Vivante Health Digital Therapeutics
AiCure Drug R&D: Clinical Trials
Emulate Drug R&D: Clinical Trials
LinkDoc Technology Drug R&D: Clinical Trials
Teckro Drug R&D: Clinical Trials
Atomwise Drug R&D: Drug Discovery & Development
Benchling Drug R&D: Drug Discovery & Development
Insitro Drug R&D: Drug Discovery & Development
OWKIN Drug R&D: Drug Discovery & Development
RDMD Drug R&D: Drug Discovery & Development
Recursion Pharmaceuticals Drug R&D: Drug Discovery & Development
Vineti Drug R&D: Drug Discovery & Development
Aetion Drug R&D: Real-World Evidence
Evidation Health Drug R&D: Real-World Evidence
GNS Healthcare Drug R&D: Real-World Evidence
Medbanks Network Technology Drug R&D: Real-World Evidence
Syapse Drug R&D: Real-World Evidence
Tempus Drug R&D: Real-World Evidence
TriNetX Drug R&D: Real-World Evidence
Verana Health Drug R&D: Real-World Evidence
23andMe Genomics
Color Genomics Genomics
Freenome Genomics
Genome Medical Genomics
GRAIL Genomics
Luna DNA Genomics
Nebula Genomics Genomics
Sophia Genetics Genomics
Viome Genomics
Accolade Insurance & Benefits
Alan Insurance & Benefits
Beam Dental Insurance & Benefits
Bend Financial Insurance & Benefits
Bright Health Insurance & Benefits
Carrot Fertility Insurance & Benefits
Cedar Insurance & Benefits
Collective Health Insurance & Benefits
Devoted Health Insurance & Benefits
Grand Rounds Insurance & Benefits
LEAGUE Insurance & Benefits
Modern Health Insurance & Benefits
Nomad Health Insurance & Benefits
Oscar Health Insurance & Benefits
Stride Health Insurance & Benefits
GoodRx Pharma Supply Chain
Hims Pharma Supply Chain
Nurx Pharma Supply Chain
Pill Club Pharma Supply Chain
Ro Pharma Supply Chain
TruePill Pharma Supply Chain
ClearCare Providers: Administrative Tools
ClearDATA Providers: Administrative Tools
HealthVerity Providers: Administrative Tools
Human API Providers: Administrative Tools
Jvion Providers: Administrative Tools
Kyruus Providers: Administrative Tools
Notable Providers: Administrative Tools
Olive Providers: Administrative Tools
Protenus Providers: Administrative Tools
Redox Providers: Administrative Tools
Solv Health Providers: Administrative Tools
SYNYI.AI Providers: Administrative Tools
Weimai Providers: Administrative Tools
DocPlanner Providers: Clinical Tools
Gauss Surgical Providers: Clinical Tools
KenSci Providers: Clinical Tools
MDClone Providers: Clinical Tools
MORE Health Providers: Clinical Tools
Oncology Analytics Providers: Clinical Tools
PatientPing Providers: Clinical Tools
Quartet Health Providers: Clinical Tools
Solera Providers: Clinical Tools
Suki Providers: Clinical Tools
Unite Us Providers: Clinical Tools
Welkin Health Providers: Clinical Tools
Vim Providers: Clinical Tools
Cityblock Health Providers: Primary Care
Iora Health Providers: Primary Care
One Medical Providers: Primary Care
Parsley Health Providers: Primary Care
Tencent Trusted Doctors Providers: Primary Care
We Doctor Providers: Primary Care
Galileo Health Providers: Primary Care (Virtual-Only)
Halodoc Providers: Primary Care (Virtual-Only)
98point6 Providers: Primary Care (Virtual-Only)
Ada Health Providers: Primary Care (Virtual-Only)
American Well Providers: Primary Care (Virtual-Only)
Babylon Health Providers: Primary Care (Virtual-Only)
Buoy Health Providers: Primary Care (Virtual-Only)
Doctolib Providers: Primary Care (Virtual-Only)
Doctor On Demand Providers: Primary Care (Virtual-Only)
K Health Providers: Primary Care (Virtual-Only)
Kry Providers: Primary Care (Virtual-Only)
Lyra Health Providers: Primary Care (Virtual-Only)
MDLIVE Providers: Primary Care (Virtual-Only)
Zava Providers: Primary Care (Virtual-Only)
Cricket Health Providers: Specialty Care
DispatchHealth Providers: Specialty Care
Kindbody Providers: Specialty Care
Xiaolu Yiguan Providers: Specialty Care
AbleTo Providers: Specialty Care (Virtual-Only)
Maven Clinic Providers: Specialty Care (Virtual-Only)
Talkspace Providers: Specialty Care (Virtual-Only)


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 Contact our official partner, Wrights Media, about available usages, license fees, and award seal artwork at cbinsights@wrightsmedia.com. Please note that Wright’s Media is the only authorized company that we’ve partnered with for CB Insights materials.