Weekly news update

DATA SECURITY BREACH : Error Exposes 1.5 Million People’s Private Medical Records on Amazon Web Services (20/9/2015)

1. Police injury reports, drug tests, detailed doctor visit notes, social security numbers—all were inexplicably unveiled on a public subdomain of Amazon Web Services.
2. Data dumps can show up on Amazon’s cloud computing platform. An enormous data breach was discovered that left the private medical information of millions of Americans sitting in the open online.
3. The data came from Systema Software, a small company that manages insurance claims.
4. No matter what the timeframe, the neglect could be a HIPAA violation: Systema failed to protect the security of patients’ electronic medical information.
5. This should be a wakeup foghorn for companies storing electronic medical records. Bad security hygiene has the potential to be just as damaging as malicious hackers.
6. Reader opinions: The cloud is totally safe if you set it up to be totally safe. But you have to do that. The cloud isn’t magic, it’s just convenient (and powerful) tools wrapped around virtualized server instances. But like any tool, they only do what you tell them to do, and if you don’t tell them to protect your data, they won’t do it.

MENA Healthcare: E-health and Egypt: the who’s who (15/9/2015)

1. Problem in public health system: Stray animals and raw sewage being found in hospitals and major corruption throughout the sector.
2. Important stats: 87 million Egyptians and 5.1% of GDP spent on healthcare
3. Health tech : wearables, websites, smart devices and new medical systems.

Wearables (pre-market stage: prototyping): 

1. Mubser: Wearable belt with a Bluetooth headset designed to  guide their movements of visually impaired people. The business is currently on hold, says CEO Khaled Abo Shady.
2. Vound: Augmented reality device designed to help the deaf. Founder Aly Mohamed says they’re onto the third prototype, and he’s about to leave for a year in Switzerland.

E-health services:

1. Ekshef:  Cofounded in 2011 by CEO Mostafa Nageeb and Mohammad Hindawi. The platform is a combination of directory and online reservations for medical services.
2. Infomed: Amir Kalila founded it at the start of 2015. This platform combines a directory with an in-house online medical practice.
3. Smart Care medical services: Founded in 2009 by Amr El Tayeb, to provide corporate clients customized , discounted health care plans. El Tayeb joined the Endeavour entrepreneur network in 2013.
4. Shezlong: Offers an online psychotherapy subscription service and currently has about 600 clients. CEO Ahmed Abu ElHaz says they operate in six countries – in English and Arabic – and are looking for six new therapists to allow them to expand further.

E-commerce

1. Agzakhana: Egypt’s first online pharmacy – launched in 2008. Founder Ahmed Shabana previously told Wamda that raising funds for healthcare businesses is difficult in Egypt (he bootstrapped until receiving investment from Vodafone Ventures in 2013).
2. Soukelhakim.com: Strategically based near Cairo’s largest physical medical supplies market – a backstreet behind main thoroughfare Kasr El Aini. It is Egypt’s first e-platform to sell medical equipment. Officially launched in 2015, the startup works with some of the biggest suppliers in the market – including 3M.

Social entrepreneurship

1. Law 3andak dam/If you have blood (2011): Founder Hisham Kharma. Free blood donor-recipient matching website. Blood recipients must pay for or source donations themselves before they receive them. Some private blood banks exist which sell to hospitals and clients.Almost 40,000 Facebook followers and 6,615 on Twitter.
2. Give me Hope (2013): Founder Amgad Morgan. Free blood donor-recipient matching app. Plans to set up donations kiosks and iPads in public hospitals through which doctors can make donation requests through the app. Recipients can search donors and blood banks nearby via an in-app map. Available in 8 languages.
3. Faselty (2012): Founder Samar Ali. Free blood donor-recipient matching app and website.Working on a new website and a crowdfunding campaign.Links donors, hospitals and blood banks via blood type and location.
4. Medicine for All (2013): Medicine recycling. We collect medicine equivalent to about $255,000 and we redistribute about 60% to patients uncovered by health insurance – about 200,000 people. Medicines from chronic diseases like hypertension and diabetes.

Hardware and diagnostics

1. Nano Ebers: The startup got off the ground last year It’s the first nanofibre would dressing to use a very high honey concentration as an antibacterial and to help moist wound healing. They are seeking funding and partnerships to commercialize the prototypes.
2. D-Kimia diagnostics: Spun off from the American University in Cairo in 2013, D-Kimia’s main focus is on developing new diagnostic processes to tackle Hepatitis C and other diseases.

Do You Really Know SaaS Economics?

https://insight.healthfundr.com/blog/mrr-cac-cltv-churn-and-the-basics-of-software-as-a-service-saas-economics-in-health-startup-investing

1.  A company’s mastery of numbers and ratios gives keen insight into how well they understand the levers of their model.

SaaS explained:

1. Software as a Service (SaaS) – SaaS is a revenue and distribution model for software companies. SaaS companies make money by charging customers on a regular basis (usually monthly or annually) for access to their software. Customers typically access the software over the internet through a computer or mobile device. Rather than building and releasing new versions on some schedule (like most versions of Microsoft Office), the company constantly updates and distributes the software over the internet. Because they centrally host their software in the cloud (usually), they can do this. Two examples of SaaS products that lots of people use are Athenahealth and Salesforce.
2. Monthly Recurring Revenue (MRR) – This is the amount of licensing fees a company receives each month. This is roughly their monthly gross revenue. If a company has 100 customers paying $100 per month (or $1200 per year), their MRR is 100 X $100, or $10,000.
3. Customer Lifetime Value (CLTV) – This is the lifetime value of each customer. In SaaS, this is typically amount customers pay each month or year x how long the average customer is likely to be a customer. Because SaaS companies don’t sell one large license up front, they capture revenue from customers over time. For example, if an average customer pays $500 per month and and the company estimates that each customer wil stay with them for four years, then their CLTV is 48 months X $500, or $24,000.
4. Customer Acquisition Cost (CAC) – This is the total cost to acquire a single customer, to bring them through the front door. It includes all marketing, sales, and other costs related to bringing in new customers. Calculating this can get somewhat complex and it can be hard for early-stage companies to know precisely.
5. Customer Retention Cost (CRC) – This is more of an emerging term than the others, but it’s very, very useful. If CAC is the cost to bring a customer through the front door, CRC is the cost to keep them around. It includes onboarding, training, support, and any other costs related to keeping customers happy and paying. Often, these costs fall under a concept SaaS companies call Customer Success.
6. Churn – For SaaS companies, churn is the percentage of customers that leave (stop paying) over a particular time period (typically per month). For example, a 10% monthly churn rate means that every month, 10% of the company’s customers stop paying for the company’s software. Caclulating this : (new customers + new revenue from existing customers)- customers lost.

GENOMICS: Kuwait attempting to genotype entire population as counter-terrorism measure (9/9/2015)

DNA testing and genomics is now so prevalent there are national genotyping platforms.

Examples:

1. The Faroe Islands, an autonomous region of Denmark, is sequencing its population of 50k. GenomeDenmark released its first 30 reference genomes.
2. The Genome of the Netherlands project published a reference genome for the Dutch based on 750 genomes from two-parent-one child ‘trios’.
3. Genomic England is working on a 100k genomes project. The United States is interpreting a million genomes as part of Obama’s precision medicine initiative.
4. The Korean Genome project aims to sequence all 50 million living Koreans.

Post ISIS attack, Kuwait ruled to instate mandatory DNA-testing for all permanent residents.

An initial $400 million dollars is set aside for collecting the DNA profiles of all 1.3 million citizens and 2.9 million foreign residents.

Database launch: September 2016

MENA Healthcare: Telemedicine in the Middle East, the time is now (2/9/2015)

1. Definition: Telemedicine constitutes the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.
2. The applications can involve two modes of communication: real-time (synchronous) – such as when consulting a remote specialist or conducting continuing medical education – or store-and-forward (asynchronous), where digital data is transmitted to a practitioner in order to acquire additional input for a diagnosis.
3. Doctors spend a lot of time with patients who don’t need to be in their clinic. A quick video consultation to diagnose a common cold or asynchronous messaging frees up that doctor’s time to see several more patients for routine issues or dedicate their attention in-person on trickier cases.
4. We’re going through an exciting transition in medicine thanks to the phenomenal growth of cognitive computing, analytics and ubiquitous broadband connectivity,” says Brian de Francesca , founder of Dubai-based Ver2 Digital Medicine which offers integrated digital medicine services.
5. Startup Health-backed AlemHeath, Malek believes the young enterprise will address the growing chasm in provision of quality healthcare in developing nations and war-torn areas.AlemHealth creates a low-cost, low bandwidth approach to diagnostic telemedicine that is ideally suited to resource limited areas or rural areas in semi-developed countries.
6. Medical education: The production of qualified medical staff is a constant requirement for healthcare systems across the globe, however access to continuing medical education about the latest research and practices is prohibitive due to cost. His solution? A simple video conferencing program virtually connecting students to medical professionals.
7. Lebanese entrepreneur Ziad Sankari established CardioDiagnostics.Our niche focus is on mobile cardiotelemetry and we’re now moving from the diagnostic space into the wearables arena, to allow preventive care as well.

For telehealth to grow in the region, there need to be a number of factors in place:

1. An agile and advanced regulatory infrastructure. Ragy Khairy, founder of telehealth platform Eshraq explains: “Medical regulation in this part of the world is still evolving. When it comes to regulation pertaining to telemedicine, it’s entirely uncharted waters.
2. Investing in outcome-based health practices and technology versus expensive hospital construction. Healthcare needs innovation, not architectural creations. Creating a world-class healthcare system of the future relies on harnessing technology that takes both physicians and patients into account.
3. Policies and practices to encourage a rich ecosystem for medical innovation. As a greenfield, the Middle East is in prime position to learn from the mistakes of mature healthcare ecosystems. A collaborative national or even regional platform that involves medical practitioners, students, researchers and healthcare investors could set the tone for the future.
4. More investors with a solid understanding of impact investing and the unique forces affecting healthcare startups. Both Khairy and Malek rue the general investor appetite for healthcare startups in the region. “Locally, one of our investors is WOMENA, and while there are some visionary and pioneering investors, by and large it seems most regional investors veer towards startups in the food delivery, retail and fashion sectors versus fledgling healthcare enterprises that save lives.”