Breyer Capital’s Healthcare AI Investment Thesis: Learnings and Predictions (December 2021 Update and Big Announcement)

Update: The last several years have been exciting for Breyer Capital as we’ve devoted significant time and resources to identify and invest in the world’s most promising healthcare AI opportunities and founders. As 2021 comes to a close, I couldn’t be more excited by our portfolio. I also know the best is yet to come.

I’ve mentioned in past emails that I could never do this work alone. Healthcare AI is complex and changing quickly and I owe a debt of gratitude to the women and men who have helped us make sense of this space. One such individual, Leo Grady, has been incredibly generous with his time and mind. Today I am thrilled to announce that Leo will be joining Breyer Capital as a CEO in Residence.

Leo was a world-class CEO and leader at Paige. Listing all of his and the company’s accomplishments would take too much time, but I will shine a light on one in particular: Paige receiving the first-ever FDA approval for an AI product in digital pathology. Tim Stenzel, a director in the FDA’s Center for Devices and Radiological Health sums up the achievement well, “Pathologists examine biopsies of tissue suspected for diseases, such as prostate cancer, every day. Identifying areas of concern on the biopsy image can help pathologists make a diagnosis that informs the appropriate treatment. The authorization of this AI-based software can help increase the number of identified prostate biopsy samples with cancerous tissue, which can ultimately save lives.”

Leo has 18 years of experience leading development and commercialization of advanced machine learning, AI, computer vision, diagnostic, and digital health technologies that have made a significant impact on healthcare practice. During his tenure as CEO of Paige, where Breyer Capital is a founding investor, Leo led the company to become an industry leader, internationally launched several groundbreaking software products, and became the first-ever company to receive FDA approval for an AI product in pathology.

Prior to joining Paige, Leo was the SVP of Engineering for HeartFlow, where he led full-stack technology and product development efforts for HeartFlow’s cardiovascular diagnostic and treatment planning software while also driving HeartFlow’s IP portfolio. Before HeartFlow, Leo served in various technology and leadership roles at Siemens healthcare. Leo is internationally recognized as a technology leader in AI for healthcare, authoring two books, over 100 peer-reviewed scientific papers, and having over 300 patents worldwide. Winner of the 2012 Edison Patent Award, he was inducted as a Fellow in the American Institute for Medical and Biological Engineering. Leo received a B.Sc. degree in Electrical Engineering from the University of Vermont and a Ph.D. in Cognitive and Neural Systems from Boston University.

I am certain that Leo will be an asset to our founders and management teams, and I feel honored that he chose Breyer Capital for this next chapter of his career.

Leo joining the team couldn’t have come at a better time. Since my last Healthcare AI update, our portfolio has grown and we continue to initiate and see remarkable opportunities. In the summer I announced our investments in Ansible Health, Iterative Scopes, OM1, Verana Health, and ClosedLoop AI. Today I am thrilled to announce investments in MyOme, Enable Medicine, SiteRX, and Tympa Health. More about these companies can be found in the appendix where the rest of our Healthcare AI portfolio is listed.

In the months to come, I will share another exciting update about how I and Breyer Capital are thinking about quantum technologies, sensing, and communications. I will highlight a new investment in the space that could, in conjunction with Healthcare AI improvements, make a profound positive impact.

In the meantime though, I hope everyone can find the time and space to enjoy this holiday season. While the last few years have been difficult for many, I remain inspired by our healthcare founders, management teams, and co-investors committed to saving patient lives and transforming the field.

Since 2016, I’ve been fascinated, excited, and inspired by advances in artificial intelligence, especially when applied to healthcare. I recently wrote a post detailing how I think about AI investing. There, I had an opportunity to share that I’ve never been more confident that artificial intelligence will help companies, institutions, and individuals accomplish extraordinary things for the betterment of humanity. In a world where AI can be a controversial topic, I often get asked why I’m optimistic. The truth is, I’ve always been an optimist. I said as much to my friends at Forbes in 2018 and feel the same way today that I felt then.

“I tend to be much more of an optimist when I think about history. In the 1960s, with all of the advances in biology, so much of it was being applied to better healthcare and to medical breakthroughs, not to biological weapons. I feel the same way today about AI and the benefits of human-assisted [artificial] intelligence in areas such as cancer and healthcare, and in improving healthcare outcomes, patients’ experiences and their ability to understand their medical records, and in doing research around medicine, which is assisted by technology. These are profoundly positive applications of AI, and I tend to be very optimistic.”

At a time when healthcare innovation has never been more important and during a week when some of the best minds are meeting, as they have for the last thirty-nine years, to discuss healthcare investing at the J.P. Morgan Healthcare Conference, I thought this would be an ideal opportunity to share more about how I’m thinking about Healthcare AI investing.

Before speaking about specific current portfolio companies of Breyer Capital, I’ll share some broader thoughts about the vertical.

While AI algorithms are still in their early stages, we can expect to see many more research breakthroughs in the coming months and years. Especially as data sets become larger and more accessible and computational power becomes more affordable, AI applications will become more powerful and ubiquitous.

It seems clear to me that AI applied to human-assisted diagnosis and analysis will create hundreds of billions of dollars of market cap by venture-backed startups. More importantly, if ethically and effectively harnessed, AI breakthroughs will improve patient lives and, perhaps counterintuitively, the patient experience. Many people imagine that AI will make medicine less human. We believe that the opposite is true. We think that a world enriched by better technology will allow doctors to spend more time caring for patients and providing personalized care.

In the short and long-term, AI will have dramatic positive effects when it comes to helping companies and institutions with workflow optimization (revenue cycle management), imaging (diagnosis and workflow efficiency), clinical trial recruitment and retention, and drug discovery. Breyer Capital has backed companies pursuing each of these opportunities and we continue to work with our university research partners to identify new approaches and tackle larger problems.

Universities and our current and future university partnerships are among Breyer Capital’s most valuable resources when it comes to Healthcare AI investing. Top universities around the world remain the best places to foster and identify AI talent. Every year I like to spend very significant time on university campuses across the country and world. In 2020, I spent extremely valuable time with deans, professors, post-docs, graduate students, and undergrads, and while I traveled far less, I found Zoom to be an effective way to connect with esteemed academic researchers. While we work closely with many universities, Harvard, Stanford, UT Austin / Dell Medical School, MIT, UCSF, Tsinghua, and Peking University are some of Breyer Capital’s closest partners. I’m also a Founding Member of the Stanford Institute for Human-Centered Artificial Intelligence and think as highly of John Etchemendy and Fei-Fei Li as anyone in the space. In 2021 when it becomes safe to do so, I look forward to visiting more schools and getting a better sense of the budding AI talent located around the world.

Breyer Capital is fortunate to be working closely with superb investors and technology/healthcare leaders such as Marc Benioff, Sam Palmisano, Nitin Nohria, Gerald Chan, Doug Leone, Marty Chavez, Helena Foulkes, Steve Kraus, and Morgan Cheatham among others. We also spend time with leaders at some of the most forward-thinking tech companies, brainstorming and thinking through long term opportunities in AI. We marvel at the intellectual horsepower of individuals such as Jeff Bezos, Sheryl Sandberg, Mark Zuckerberg, Tim Cook, Satya Nadella, Doug McMillon, Larry Page, and Sergey Brin. We’ve also been so encouraged by brainstorming sessions with the Austin entrepreneurship and investing community and are grateful to be sharing notes with Michael Dell, Brett Hurt, Adam Zeplain, Josh Baer, Krishna Srinivasan, Ross Perot Jr, Tom Luce, and Joe Aragona.

Thanks to wonderful partners, we’ve been able to invest in some groundbreaking healthcare AI companies. I won’t name all of them here and there are many that are remaining stealth for the time being, but I’ll highlight a few below to demonstrate some examples of how healthcare AI will be world-changing.

We believe that the intersection of healthcare and AI, as we have said broadly about AI over the last 5 years, will be the financial and impact opportunity of this decade, rivaling previous technology breakthroughs such as social networks and the internet.

If you’re a leader at a health institution, university, healthcare company, AI lab, or pursuing a different healthcare opportunity, Breyer Capital hopes to hear from you.

FEATURED HEALTHCARE AI INVESTMENTS:

23andMe: I believe 23andMe’s next chapter will be even more exciting than its trailblazing start. 23andMe has crowdsourced billions of data points, which (stripped of personally identifiable information) I believe will lead to new scientific discoveries and novel treatments for disease. Collaborations with pharma companies, universities, and hospitals will allow 23andMe to forge a future where healthcare is more personalized and medicine is more effective.
Ansible Health: Ansible Health provides home-based healthcare services to patients suffering from chronic obstructive pulmonary disease (COPD) in the United States. Ansible Health does this by leveraging technology as well as their own clinical teams of respiratory therapists, and MDs, to remotely monitor, educate, coach, and provide rehab to these patients. They work alongside their current clinical providers to ensure that these patients live long, healthy, and fulfilling lives.
C3.ai: Breyer Capital is so proud to have been an early investor in my friend Tom Siebel and C3.ai, which recently listed on the NYSE. In healthcare, C3.ai helps payors, providers, and suppliers analyze massive amounts of clinical, claims, pharma trial, EMR, and sensor data to clarify and optimize decisions about how best to care for patients and reduce the overall cost of care.
ClosedLoop.ai: ClosedLoop.ai is healthcare’s data science platform. The company makes it easy for healthcare organizations to use AI to improve outcomes and reduce costs. Purpose-built and dedicated to healthcare, ClosedLoop combines an intuitive end-to-end machine learning platform with a comprehensive library of healthcare-specific features and model templates. Customers use ClosedLoop’s Explainable AI to drive clinical excellence, operational efficiency, value-based contracts, and enhanced revenue.
Earli: Earli is a biotechnology company born out of Stanford University focused on making cancer detectable, localizable and therefore treatable at an early stage. By forcing cancer cells to produce synthetic biomarkers that do not belong in the human body, these cells become visible in a PET scanner, so they can be treated at early stages. Earli uses biology rather than chemistry to force production of the Synthetic Biopsy, allowing for massive signal amplification and targeted treatment.
Elemental Cognition: Founder/CEO of Elemental Cognition, Dr. David Ferrucci, built and led the IBM Watson team from its inception through its landmark Jeopardy success in 2011. Today, Elemental Cognition is driving the future of AI by changing the way machines learn. In the next ten years, I believe that the healthcare implications of their technology will be significant as an AI that can learn, understand, and explain what it reads could add momentous value to doctors and patients.
Enable Medicine: Enable Medicine is an end-to-end spatial biology platform. The company provides custom panel development for a wide variety of targets and biomarkers and data acquisition utilizing the CODEX imaging platform. Their fully cloud-based bioinformatics pipeline takes in these ultra high-plex images and most other immunofluorescent image types to conduct spatial data analysis with proprietary software tools.
Iterative Scopes is a software-only gastrointestinal data company, working to deliver AI toolkits to the practice of gastroenterology, to provide real-time actionable insights to providers
Lyra Health: I met Lyra’s co-founder and CEO, David Ebersman, when we recruited him to be Facebook’s Chief Financial Officer. When he left to start Lyra Health, I was eager to partner for a second time. Today more than 40 leading companies have partnered to offer Lyra’s mental health benefits to their employees, including Facebook, Pinterest and Starbucks, giving more than a million people access to life-changing care.
MyOme: MyOme is a personal genetics company that helps families understand their medical backgrounds through DNA testing. Licensed physicians are able to order tests, and genetic counselors are then provided to customers for full understandings of genetic histories
OM1: OM1 has built an intelligent data cloud to enable different healthcare stakeholders to cost-effectively access, analyze, and use outcomes data in a more robust, clinically meaningful, and precise way.
Paige: Breyer Capital is a founding investor in Paige. Paige has already reached impressive milestones like being the first AI company in pathology to get an FDA breakthrough designation and a CE Mark. Paige sits at the forefront of scientific innovation for AI-based diagnostics in clinical and biopharma applications.
Related Sciences: At Facebook, Jeff Hammerbacher was an instrumental member of the early team, leading the company’s efforts in data collection, management, and analysis. It was an easy decision to invest in Cloudera, and an even easier decision to invest in his latest endeavor. The Related team is committed to discovering new medicines for diseases with unmet needs. They are building a data-driven platform for translating science into valuable drug candidates.
SiteRx: SiteRx is on a mission to bridge clinical trials with clinical practice, making access to appropriate clinical trials available to any patient that qualifies and wishes to participate. By accomplishing this, we give treating physicians an opportunity to provide additional care options for their patients while generating significant new income for their practices. We also improve things dramatically for sponsors and sites who consistently struggle to recruit the right patients, wasting precious time and money, and delaying the approval of potentially life-saving treatments.
Slope: Clinical trials depend on proper tracking and management of drugs, devices, kits, samples, and equipment. Mismanagement of the above impact 94% of clinical trials. Slope solves the complexity, operational inefficiency, and data integrity issues that plague clinical trials. Their data-driven approach to clinical supply chain management helps clinical trials stay on track. The three tenets of the business are order, trust, and predictability, each of which is enabled by AI-based infrastructure.
Soley Therapeutics: We partnered with a top medical center to develop safe and effective new drugs for the treatment of a broad spectrum of diseases. Using disruptive and proprietary technology, including some novel AI and Deep Learning applications, this opportunity could transform drug development
Subtle Medical: Breyer Capital is a proud seed investor in Subtle Medical, a company that has the first FDA-cleared AI software solutions for medical imaging enhancement. Subtle’s current clinical partners include UCSF, Hoag Hospital, Mt. Sinai, and others. The company aspires to make medical imaging better, safer and more comfortable for patients while creating new workflow efficiencies for hospitals and imaging centers.
Suki: Suki is an AI-powered, voice-enabled digital assistant for doctors. Suki’s mission is to lift the administrative burden from doctors, so they can focus on what matters. Suki was founded by Punit Soni, a Google and Flipkart executive. In 2019 Google named Suki their AI partner of the year and in 2020 they were selected by Fast Company as one of the 100 most innovative companies.
Tympa Health: TympaHealth has developed the world’s first ear and hearing health assessment system. The Tympa system empowers non-specialists to perform high-definition digital otoscopy, micro-suction wax removal, and a hearing screening, all in a single 30-minute appointment. Users can also upload patient images and video to the secure cloud, where they can be reviewed by ENT specialists anywhere in the world.
Verana Health assembles clinical databases in medicine to empower physicians and accelerate research for patients.
You.com: We just announced our Marc Benioff co-investment in Richard Socher’s You.com. Richard and team are building the first “trusted search engine.” The Internet is full of amazing and useful information but also junk, fake reviews, biases and unhelpful ads. When individuals are looking for health information and resources, bad actors are especially pernicious. You.com aspires to make accurate medical information more transparent and accessible on the internet.

@BreyerCapital Venture Capital/Venture Philanthropy in Austin, Texas and Silicon Valley