Mental Health Startup Uses Voice ‘Biomarkers’ To Detect Signs Of Depression And Anxiety

Young female character having a panic attack, an imaginary monster shadow silhouette, mental health issues, psychology

The quick brown fox jumps over the lazy dog,” Rima Seiilova-Olson says slowly and emphatically over Zoom.

The simple sentence holds enormous value for mental health care, she explains, smiling as if to acknowledge that it might be less than obvious how a silly phrase could be so meaningful to a computer programmer and leader of an artificial intelligence startup.

The short saying contains every letter of the alphabet and phoneme in the English language, says Seiilova-Olson, an immigrant from Kazakhstan who is cofounder and chief scientist of Kintsugi Mindful Wellness. Kintsugi believes these sounds offer invaluable insight that can help mental health providers better support people with depression and anxiety.

The Bay Area-based company is building AI software that analyzes short clips of speech to detect depression and anxiety. This so-called voice biomarker software is being integrated into clinical call centers, telehealth services and remote monitoring apps to screen and triage patients reaching out for support, helping providers more quickly and easily assess their needs and respond.

“There’s just not a lot of visibility as to who is severely depressed or anxious.”

Kintsugi CEO and co-founder Grace Chang

Seiilova-Olson, 36, first met co-founder and CEO Grace Chang, 40, a Taiwanese immigrant now based in Berkeley, in 2019 at an open AI hackathon in San Francisco. Surprised to cross paths at a male-dominated event, the women began comparing notes about their respective personal challenges trying to access mental health care:

Seiilova-Olson had struggled to secure a therapist during postpartum depression with her first child, and when Chang had needed her own support, she said it had taken months for anyone from Kaiser to call her back.

“Living in the Bay Area, you can push a button and a car can come to you or food can come to you,” Chang says. “But this was really a challenge.” As engineers, they viewed the dilemma differently than clinicians might.

“We saw this as an infrastructure problem, where you have so many people trying to jam through that front door,” Chang explains. “But there’s just not a lot of visibility as to who is severely depressed or anxious, who is low-to-moderate. And if we could provide this information to those frontline practitioners, then we’d maybe have an opportunity to greatly alleviate that bottleneck.”

Kintsugi was born out of that idea in 2019. It sits in a competitive space of health tech startups like Ellipsis Health and Winter Light Labs that are using voice biomarkers to detect mental health or cognitive issues, built on research showing that certain linguistic patterns and characteristics of a person’s voice can be correlated with psychiatric or neurological conditions.

Kintsugi last year raised $8 million in seed funding led by Acrew Capital, and in February, announced it had closed a $20 million Series A round led by Insight Partners, which valued the company at nearly $85 million, according to PitchBook.

In-person mental health facilities typically use questionnaires to gauge the severity of patients’ anxiety or depression, measures known as PHQ-9 and GAD-7 scores. But during telehealth visits or phone consults — where face-to-face interaction is lost, making it harder to pick up on symptoms — Kintsugi’s technology helps to fill that gap.

Nicha Cumberbatch, assistant director of public health at Spora Health, a provider focused on health equity and people of color, uses Kintsugi’s software to assess women in its all-virtual, doula-led maternal health program, Spora Mommas.

The voice analysis tool, which Spora began using for patient consultations a few weeks ago, has helped Cumberbatch identify women who are, or may be at risk of, experiencing anxiety and depression before, during or after their pregnancies. When a patient starts speaking to a Spora clinician or doula on Zoom, Kintsugi’s AI begins listening to and analyzing her voice.

After processing 20 seconds of speech, the AI will then spit out the patient’s PHQ-9 and GAD-7. The employee can then use that mental health score to decide what additional testing may be needed and how best to advise or direct the patient to resources — like a psychiatrist, cognitive behavioral therapist or obstetrician.

Cumberbatch says Kintsugi’s technology is allowing her to “​​keep a more watchful eye” on her patients “and then move forward with proactive recommendations around mitigating their symptoms.” And while it’s not meant to replace clinicians or formal medical evaluations, she adds, it can be used as a screening tool to “allow us to have a more well-rounded, 360-view of the patient when we don’t have them in front of our face.”

“That technology… [allows] us to have a more well-rounded, 360-view of the patient when we don’t have them in front of our face.”

Nicha Cumberbatch, assistant director of public health at Spora Health

Dr. ​​Jaskanwal Deep Singh Sara, a Mayo Clinic cardiologist who has collaborated with Ellipsis and led research on potential uses of voice biomarkers for cardiology, cautions that while the technology is promising for health care, the field has a long way to go to ensure that it’s accurate, safe and beneficial for patients and clinicians alike.

“It’s not ready for primetime by any stretch of the imagination yet,” Dr. Sara says. Studies in psychiatry, neurology, cardiology and other areas have shown an association between voice biomarkers and various conditions or diseases, but they haven’t shown how this relationship can be used to improve clinical outcomes, he says.

Such research is “not the same as saying, ‘How can we instrumentalize it in clinical practice, and how feasible is it? How effective is it in gauging an individual’s medical trajectory?’” he explains. “If it doesn’t provide any benefits in terms of how we manage them, then the question is: why would you do it?”

He says addressing those questions is “one of many next steps that we have to undertake on this” and that larger clinical trials are needed to answer them. “If it makes health care delivery cheaper or more efficient, or if it improves outcomes for patients, then that’s great,” he adds. “But I think we need to demonstrate that first with clinical trials, and that hasn’t been done.”

To address these issues and validate its software, Kintsugi is conducting clinical studies, including with the University of Arkansas for Medical Sciences, and the National Science Foundation has awarded Kintsugi multiple grants to ramp up its research. The company is also pursuing FDA “de novo” clearance and continuing to build its own dataset to improve its machine learning models.

(Data and insights from Kintsugi’s voice journaling app, as well as conversations with call centers or telehealth providers and clinical collaborations with various hospitals, all become part of an enormous dataset that feeds Kintsugi’s AI.) Seiilova-Olson says this self-generated, unfettered proprietary dataset is what sets Kintsugi apart in the AI health care space — where many technologies are reliant on outside data from electronic health records.

That collection of troves of data on individuals’ speech can be concerning — particularly in the mental health and wellness space, which is widely considered a regulatory Wild West. (These products and services are often not subject to the same laws and stringent standards that govern how licensed clinicians provide formal medical care to patients.)

But Kintsugi’s founders say that patient privacy is protected because what matters for its technology is not what people are saying, but how they are saying it. Patients are also asked for their consent to be recorded and care is not affected by their decision to opt in or opt out, according to the founders.

Kintsugi says it has served an estimated 34,000 patients. The company is currently working with a large health system with 90 hospitals and clinics across 22 states, and they are active in a care management call center that services roughly 20 million calls per year. It is also partnering with Pegasystems, which offers customer service tools for health care and other industries, to help payers and providers handle inbound calls.

Chang says other customers include Fortune 10 enterprise payers, pharmaceutical organizations and digital health applications focused on remote patient monitoring, but that she could not yet share their names. Kintsugi’s clinical partners include Children’s Hospital Colorado, Joe DiMaggio Children’s Hospital in Florida, Chelsea and Westminster Hospital in London and SJD Barcelona Children’s Hospital in Spain, Chang said.

Prentice Tom, Kintsugi’s chief medical officer, adds that it’s working with the University of Arkansas to explore how the tool can be used to possibly identify patients with suicidal ideation, or increased or severe suicide risk, as well as with Loma Linda University, to look at how the technology can be used to spot burnout amongst clinicians.

The team is also looking for ways to expand availability and uses for younger and elderly patients, as well as for maternal and postpartum populations. And beyond patients themselves, it’s perhaps nurses who are benefiting most from Kintsugi’s work, according to the founding team: having a triage tool that helps reduce administrative work or the time spent asking generic questions enables nurses to more seamlessly move patients in their journey.

But Tom, a Harvard-trained emergency medicine physician and former faculty member at Stanford University’s Department of Emergency Medicine, says Kintsugi is now doing far more than addressing infrastructure issues alone. It’s democratizing access to mental health care, Tom said, moving away from a physician-centric paradigm that caters more to people with significant enough depression that they require medical evaluation.

“This tool actually creates a view of mental health in terms of mental wellness,” Tom said, “where everyone has the opportunity to understand where they sit on the spectrum and that actually stratifies treatment options well beyond the current infrastructure.”

I’m a Senior Writer at Forbes covering the intersection of technology and society. Before joining Forbes, I spent three years as a tech reporter at Politico, where I covered

Source: Mental Health Startup Uses Voice ‘Biomarkers’ To Detect Signs Of Depression And Anxiety


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Microsoft System Blamed for New Jersey Vaccine-Booking Glitches

New Jersey officials are blaming Microsoft systems that were supposed to help vaccination efforts for allegedly glitching over the past five weeks, hindering the ability for a smooth vaccination rollout in the state. 

The state’s Microsoft system for running the vaccination rollout has had issues daily from booking appointments to losing registrations, state government officials told Bloomberg News

State officials blamed issues they said seem to stem from Microsoft not having enough employees staffed to deal with the issues and having employees in time zones that make them unavailable to help during business hours.

Vaccination rollout has been a major operation for states struggling to keep track of vaccinations and standardize strict guidelines for who medical facilities are allowed to vaccinate. 

Microsoft told Bloomberg that they know of some issues with the system in New Jersey, but did not comment further. 

“We are working with the state of New Jersey to deliver vaccinations as quickly, safely and efficiently as possible, and that includes addressing some technical issues,” a Microsoft spokesperson told Bloomberg.

Hospital and county websites have picked up the slack in New Jersey where the Microsoft system has failed, Bloomberg reported. More than 1.2 million vaccinations have reportedly been scheduled in the state. 

New Jersey was hit hard by the coronavirus pandemic, with more than 700,000 confirmed cases and more than 22,000 deaths from COVID-19, according to The New York Times.

Joe Biden is still aiming for 100 million people to be vaccinated within his first 100 days in office, but the process has been difficult, involving delivery delays, scheduling issues and vaccine hesitancy.

By Lexi Lonas

Tags MicrosoftJoe BidenNew Jerseycoronavirus vaccineCoronavirus

Bloomberg Quicktake: Now

Five weeks of stumbles by Microsoft Corp. on New Jersey’s Covid-19 vaccine-booking software have left the state pushing for daily fixes on almost every part of the system and doubting it will ever operate as intended, according to members of Governor Phil Murphy’s administration. The glitches — and attempted fixes that forced one megasite to go off-line temporarily — have led New Jersey to rely more on the county- and hospital-operated websites that are working well and have helped schedule more than 1.2 million doses in the most densely-populated state in the country.

Officials say those systems are successfully booking thousands of people. They fear the state’s booking portal, run on Microsoft software and functioning for just a limited number of residents, won’t withstand broad demand as eligibility eventually is opened to millions of more people. Health care has become a major focus for Microsoft, which unveiled a package of industry-specific cloud software in May. The world’s largest software company, which has hired executives with medical backgrounds, also has been researching machine learning and artificial intelligence tools for areas including clinical trials and patient care. In late January, the Redmond, Washington-based company touted its Microsoft Vaccination Management platform — usable by those seeking shots and by health providers — to register, schedule, track supplies and otherwise streamline the biggest inoculation effort in U.S. history.

The platform has yet to work correctly for New Jersey in the state’s effort to inoculate its residents against the coronavirus, according to two administration officials who asked not to be identified discussing contractual issues. Governor Murphy and State Health Commissioner Judith Persichilli acknowledged there was an issue with Microsoft in a Feb. 10 briefing, but didn’t go into detail about the problems. Since the state’s website went live Jan. 5, the software has booked thousands of appointments. But it’s also blocked users, lost registrations, double-booked residents and crashed for periods of five minutes to three days, the officials said. Though Microsoft has worked daily on the troubles, the officials said they had no confidence that they’ll get all the features called for in its contract with the company. In a statement, Microsoft acknowledged difficulties with booking shots but didn’t specify the problems. “We are working with the state of New Jersey to deliver vaccinations as quickly, safely and efficiently as possible, and that includes addressing some technical issues,” a Microsoft spokesperson said in an email.

The New Jersey officials declined to say whether the state is considering canceling the Microsoft contract, but said they are seeking solutions and workarounds of all kinds. The cost of the contract wasn’t readily available. New Jersey was among the earliest and hardest-hit U.S. states by Covid-19, recording almost 21,000 deaths with a lab-confirmed link to the disease caused by the coronavirus. Murphy, a first-term Democrat running for re-election this year, has committed to vaccinating 4.7 million people, or 70% of the state’s population, by late June. So far, New Jersey has administered nearly 1.2 million doses, representing a tenth of the population who have received at least one dose, according to the Bloomberg Vaccine Tracker. State officials said Microsoft appears to be using too few staffers, with some key personnel in overseas time zones that leave them unavailable during U.S. business hours. The officials said they’ve conferred with other states using versions of the same software, which is built on the Microsoft Dynamics customer-relationship management platform.

The task appears to be going smoother, they said, in places that asked for fewer applications — just scheduling, say, rather than more complex services. Subscribe to our YouTube channel:​ Bloomberg Quicktake brings you live global news and original shows spanning business, technology, politics and culture. Make sense of the stories changing your business and your world. To watch complete coverage on Bloomberg Quicktake 24/7, visit​, or watch on Apple TV, Roku, Samsung Smart TV, Fire TV and Android TV on the Bloomberg app. Have a story to tell? Fill out this survey for a chance to have it featured on Bloomberg Quicktake:​ Connect with us on… YouTube:​ Breaking News on YouTube:…​ Twitter:​ Facebook:​ Instagram:


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4 Reasons Your Practice Needs a Virtual Waiting Room

Technology has accelerated changes in healthcare as a result of the public health crisis, offering patients convenient and safe ways to stay connected to their doctors. Telehealth, for example, allows patients to attend doctor appointments via video technology which ensures a face-to-face interaction while enabling both patients and providers to attend the appointment in the privacy and security of their own environments. Now, in addition to telehealth visits, virtual waiting rooms have emerged as a way to help patients continue to socially distance through the check-in process before attending a visit in person or online.

What is a virtual waiting room?

A virtual waiting room is a remote way for patients to:

  • Check-in for appointments (in-person and virtual visits)
  • Complete necessary paperwork digitally
  • Receive instructions and safety protocols for in-person visits
  • Be notified of when and where to go once their doctor is ready to see them in the exam room

A virtual waiting room can be deployed in just about any kind of medical setting, giving patients the option to check-in for their appointment or a visit to the emergency room while remaining in their car until their provider is ready to see them. This reduces the amount of time patients spend around others inside the office, thereby minimizing the chances that they’ll infect others or be infected by COVID-19. Virtual waiting rooms can also be used for telehealth visits to guide the registration process and notify patients when providers are ready to initiate the visit.

There’s a variety of ways to implement a virtual waiting room solution, from using HIPAA compliant texting and chatbots to other technology that can facilitate the remote check-in process. In many cases, patients can join a virtual waiting room after receiving a link via text message. After completing any necessary digital forms online, patients are placed in a virtual queue and alerted in real-time when the doctor is ready to see them. This offers many benefits for patients seeking care at any kind of specialty clinic, hospital, or primary care office.

Reasons why you need a virtual waiting room.

1. Contactless patient registration improves COVID-19 infection control.

Using a virtual waiting room allows your patients to bypass face-to-face registration which reduces contact with staff and other patients. Because COVID-19 is spread through respiratory droplets passed through the air after a cough, sneeze, or other forceful expressions, the only way to eliminate the risk of spread is to avoid contact altogether with others. By employing a remote patient registration process using digital forms or a chatbot, medical practices can still collect the information they need and offer any support patients need while filling out forms without coming into close contact.

2. Virtual waiting rooms offer a patient-friendly experience in a comfortable environment.

The traditional waiting room experience is often frustrating and inconvenient if you think about it. Whether or not you’re sick, the waiting room is often full of people with runny noses, coughs, and crying children who are also waiting to be seen which means it’s noisy, overwhelming, and a little bit awkward. When doctors fall behind, these noises seem to multiply as every minute waiting feels like a minute lost that could have otherwise been better spent.

In contrast, virtual waiting rooms allow patients who are waiting to see their doctor in person remain in their own vehicle where they can control the temperature and noise. As they wait, they can do what they’d like with the time they have whether that’s reading a book, working on their laptop, or FaceTiming a friend. And, a virtual queue keeps them updated on how much longer they have to wait so they’re never left wondering.

For patients using telehealth visits, your staff can still capture the required information and payment virtually using waiting room solutions. Meanwhile, patients register and wait for their appointment in the comfort of their own home where they’re relaxed, socially distanced, and maybe even surrounded by a supportive family. And, patients can spend their time how they wish in a “virtual parking lot” until their provider is ready to initiate the video visit.

3. It’s easier to maintain privacy and security.

If you think back to the traditional waiting room set-up, it can be challenging to maintain a sense of privacy, especially if you’re filling out paper registration forms with nearby patients looking over your shoulder. Waiting solutions eliminate this problem while collecting private health data using HIPAA compliant technology that helps providers understand the patient’s health condition without compromising security. And, patients don’t need to remember patient portal passwords or clunky app logins to “show-up” in the waiting room. Instead, they simply confirm their identity using two-step authentication via a direct link to their phone number.

4. The entire process can be automated, saving you practice precious resources.

The best part about remote check-in is that your practice can establish automated workflows from appointment reminders to patient check-in. This frees up your staff to focus on the tasks in front of them. Text messages can be created using customizable templates that pull relevant patient data, such as their appointment date and time, while repurposing language that guides patients through the process. You can still establish ways for patients to seek extra support, such as by texting “HELP” back to the office to solicit a phone call from the staff. But, the simple step of automation can greatly speed up the registration process while capturing and syncing patient information digitally into their medical record without the manual effort.

Do you need help launching a virtual waiting room at your practice? Contact us today for a free demo.

By: ProviderTech




Virtualizing the waiting room experience will be key as healthcare providers get back to business.

This Japan Startup Is Using Deep Learning To Detect Early-Stage Cancer In Blood Samples

Imagine going for a routine blood test during an annual health checkup and being able to select a screening option that could tell you whether you have early-stage cancer. A Japanese startup is using deep learning technology to realize this dramatic advance in the fight against cancer, one of the top causes of death around the world.

A technician prepares samples at PFDeNA’s lab in Tokyo
A technician prepares samples at PFDeNA’s lab in Tokyo, where researchers are developing a screening system for early detection of cancer from blood samples. Japan BrandVoice

Unique skillsets

PFDeNA Inc. was established in 2016 as a joint venture between DeNA, a Japanese internet giant, and Preferred Networks, Japan’s leading artificial intelligence startup, to solve complex problems. One such problem is cancer detection.

PFDeNA’s cancer research can be traced back to the vision of one of Japan’s pioneering entrepreneurs. In 1999, Namba Tomoko founded DeNA, a mobile and online services company that had extraordinary success in e-commerce and gaming. Namba stepped down from her role as CEO in 2011 to care for her cancer-stricken husband, but her commitment to fighting the disease inspired DeNA to launch a healthcare business with its own bioscience lab in 2014. Meanwhile, Preferred Networks had been conducting research on cancer screening with National Cancer Center Japan since 2015, but needed a partner with expertise in lab operations and business. The two companies decided to use PFDeNA as a platform for collaboration, which began in 2018.

DeNA founder Namba Tomoko
DeNA founder Namba Tomoko’s commitment to fighting cancer inspired DeNA’s healthcare business. Japan BrandVoice

Led by board members including DeNA President and CEO Moriyasu Isao and Preferred Networks CEO Nishikawa Toru, PFDeNA is harnessing the power of deep learning, an artificial intelligence technique modeled on the brain, as a way to detect cancer as early as possible. To do that, the venture is building computer tools as well as a state-of-the art lab that will be able to find almost undetectable signs of cancer in routine blood samples. This “liquid biopsy” approach contrasts greatly with current methods such as radiographic imagining and tissue biopsies.

“We want to transform healthcare from a sick-care model, in which patients are cared for when they become ill, to one based on preventive medicine,” says Yoneyama Hiroshi, executive officer at DeNA and vice president of PFDeNA. With a background in business development and healthcare, Yoneyama is keenly aware of the challenges faced by the medical care system in Japan.

“There’s a dire need for early-cancer detection, not only in Japan but overseas as well,” Yoneyama says. “There are hurdles in the liquid biopsy field but we believe we can overcome them based on the strengths of our two founding companies.”

Each partner brings a unique skillset to the challenge. Preferred Networks’ specialty is developing cutting-edge AI solutions. DeNA is able to quickly make decisions on large-scale investments based on its long experience in mobile services. It’s also a player in the healthcare business, and has accumulated significant experience in negotiating with medical centers as well as lab operations. In 2014, DeNA began a direct-to-consumer genetic testing service called MYCODE, which can detect predisposition to a variety of illnesses. About 90% of MYCODE users have made lifestyle modifications to protect their health.   

Looking for molecular changes

PFDeNA aims to screen for 14 types of cancer, including lung and pancreatic cancer, and estimates the domestic market for such services could be worth about 400 billion yen ($3.8 billion). The startup is working to develop a system that can rapidly detect telltale signs of the 14 cancers with just one blood test. These can include changes in the number of molecules that can indicate the likelihood or presence of cancer.

Prostate-specific antigen (PSA), for instance, is a protein produced by the prostate gland that is used to screen for prostate cancer. Genetic mutations can also suggest whether a patient may be more likely to develop certain kinds of cancer. PFDeNA is examining the expression patterns of extracellular ribonucleic acid (exRNA) including microRNA (miRNA) as a potential screening tool for multiple types of cancer. Many cancer researchers expect that certain changes in these miRNA biomarkers can indicate the presence of cancer in various organs.

PFDeNA Vice President Yoneyama Hiroshi
Healthcare must be transformed from a sick-care model to one based on preventive medicine, says PFDeNA Vice President Yoneyama Hiroshi. Japan BrandVoice

“In addition to massive computational resources, high-quality data is indispensable for the high-precision deep learning computations needed to create an accurate screening system,” says Abe Motoki, a bioinformatics engineer at Preferred Networks. Abe is in charge of developing a predictive model using deep learning. He also has access to Preferred Networks’ computational resources including the MN-3 supercomputer, recently ranked as the world’s most energy efficient on the Green500 list.

“With a disease like prostate cancer, we only need to look at the levels of just one biomarker, PSA,” Abe says. “But with we are trying to detect multiple types of cancer by analyzing over a thousand exRNA expression levels, which is way more than humans can possibly handle. That’s why we need technology like deep learning.”

A powerful collaboration

Japan provides an ideal location for medical startups such as PFDeNA, in part because of readily available medical checkups covered by employers and municipalities, as well as a wealth of high-quality medical data. At its lab in Tokyo, PFDeNA is analyzing thousands of blood samples provided, with patient consent, by medical institutions such as National Cancer Center Japan. The company is working with more than 10 medical centers as it works toward its goal of building a rapid-screening system that could be part of annual medical checkups in the future. These partnerships, along with collaborations with industry and academia, form a solid foundation that’s giving PFDeNA the best chance of succeeding in its quest.

Abe Motoki, a bioinformatics engineer at Preferred Networks
An accurate cancer-screening system requires high-quality data, says Abe Motoki, a bioinformatics engineer at Preferred Networks. Japan BrandVoice

The Japanese government has also pivoted to support such efforts. With their universal healthcare system, Japanese tend to focus on treating problems, paying less attention to prevention. This tendency, along with the aging population, has increased demand for medical care. While grappling with these issues, the Japanese government is trying to transform the national healthcare system into one that focuses more on prevention. The state is also backing R&D projects in the field of early disease prediction and intervention through programs such as the Cabinet Office’s Moonshot R&D program.

“The Japanese government is very keen to come up with measures for cancer detection and prevention, so we fit into the context of what it’s doing,” says Yoneyama. “We were able to receive cooperation from more than 10 medical institutions because they’re working on this issue, and it’s now a trend. So Japan, as a government and as a whole, is very much backing this movement and taking leadership in this area.”

While PFDeNA works toward publishing the results of its research in academic journals, it’s consulting with the Pharmaceuticals and Medical Devices Agency, the authority responsible for certifying drugs and medical devices in Japan, in order to streamline approval of its services when they’re ready for the market. 

PFDeNA’s lab
PFDeNA’s lab has already processed thousands of samples in its quest to build an early cancer detection service. Japan BrandVoice

“Japan is an aging society, and early cancer detection is one way in which the burden of healthcare costs can be reduced,” says Ishikura Kiyo, associate director of PFDeNA’s healthcare business. “Liquid biopsies are a hot international topic right now. This service would be the first of its kind in the world and it’s a complex challenge to overcome. It’s a long-term journey but we have already begun.”

Note: All Japanese names in this article are given in the traditional Japanese order, with surname first.

To learn more about PFDeNA, click here (Japanese).  

To learn more about DeNA, click here.

To learn more about Preferred Networks, click here.



Japan is changing. The country is at the forefront of demographic change that is expected to affect countries around the world. Japan regards this not as an onus but as a bonus for growth. To overcome this challenge, industry, academia and government have been moving forward to produce powerful and innovative solutions. The ongoing economic policy program known as Abenomics is helping give rise to new ecosystems for startups, in addition to open innovation and business partnerships. The Japan Voice series explores this new landscape of challenge and opportunity through interviews with Japanese and expatriate innovators who are powering a revitalized economy. For more information on the Japanese Government innovations and technologies, please visit

Next Billion-Dollar Startups: Online Pharmacy Capsule Leads Healthcare- And Tech-Heavy List


When Lennie Sliwinski and Matt Pierce founded Trusted Health in 2017, they simply wanted to take what they’d learned about online marketplaces from working at Hired, and apply it to nursing. Their digital platform matches nurses with jobs, giving them more flexibility and control over their careers. Because Sliwinski’s mother worked as a nurse, and Pierce’s brother had suffered a medical error, both of them had a personal passion for the field.

But since the novel coronavirus started to spread across the U.S. this spring, San Francisco-based Trusted’s mission has become even more vital, helping place nurses from around the country in New York City’s hospitals. Last year, Trusted’s revenue reached an estimated $28 million; this year, signups by nurses and job postings on the platform are growing so fast that Pierce, 32, isn’t even estimating year-end revenues yet. “We laid out a rudimentary model at the beginning of the year,” he says. “As you can imagine, that broke.”

Trusted is one of 25 companies that made the cut for this year’s Forbes’ Next Billion-Dollar Startups list. Produced in partnership with TrueBridge Capital Partners, the list highlights the fast-growing, venture-capital-backed companies we think have the best shot of reaching a $1 billion valuation. With millions of Americans at home to fight the spread of coronavirus and unemployment at historic levels, the list reflects the bright spots in a tough economy in the throes of transformation.

Healthcare stands out with five companies, including Lyra Health (mental health benefits), Benchling (biotech R&D software), Weave (software for dentists and other medical professionals) and Capsule (tech-enabled pharmacy), in addition to Trusted Health. Last year, by contrast, there were just two healthcare startups.

Capsule is actually the largest company on this year’s list, racking up some $100 million in revenue last year by helping New Yorkers order their prescription medications by text or app, with home delivery in a two-hour window. Founder Eric Kinariwala, 37, launched the company in 2016 after a bad experience waiting in line at his local Duane Reade drugstore to pick up antibiotics for a sinus infection.

While Capsule was a convenience before the coronavirus crisis, Kinariwala figures it’s now a must-have for those customers who worry about being exposed to the virus at a store and especially for those who are elderly, high-risk or currently in isolation. It plans to expand far beyond New York City, something it should have no trouble doing since it has raised $270 million so far, more funds than any other next-billion-dollar startup on this list. “Everything is working beyond our expectations in New York,” Kinariwala says. “So now it is time to help the 97% of Americans who do not live in New York City.”

Tech companies often dominate the lineup, and all of the companies on this year’s list (including the ones in healthcare) have some technological component to them. Algolia (which powers the corporate search boxes online), Superhuman (a smart email provider) and (workflow-automation tools) are among this year’s 25. So, too, are 3 cybersecurity firms: Coalition, Expanse and Signal Sciences.

How Pharmacy Fatigue Put One Company On The Path To A Billion| 32:45

But the list’s diversity reflects how technology is being incorporated into startups across industries, including ones that are helping people through this difficult time like credit card consolidation app Tally and at-home fitness company Mirror.

Whereas previous lists have spotlighted consumer-products companies like shoe manufacturer Rothy’s and now struggling suitcase-maker Away, this year just Mirror made our cut, as the pandemic closed gyms and pushed Americans to work out at home. Retailers? Last year there were two. This year there isn’t even one.

“We’ve seen all the notes about, ‘This is the end of good times,’ and ‘Winter is here,’” says Jason Traff, cofounder of Shipwell, an Austin, Texas-based logistics startup that made the list. “I am very thankful that, compared to a lot of companies I know, we’re going to grow in 2020, and I think in all the right ways.”

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I’m a senior editor at Forbes, where I cover manufacturing, industrial innovation and consumer products. I previously spent two years on the Forbes’ Entrepreneurs team. It’s my second stint here: I learned the ropes of business journalism under Forbes legendary editor Jim Michaels in the 1990s. Before rejoining, I was a senior writer or staff writer at BusinessWeek, Money and the New York Daily News. My work has also appeared in Barron’s, Inc., the New York Times and numerous other publications. I’m based in New York, but my family is from Pittsburgh—and I love stories that get me out into the industrial heartland. Ping me with ideas, or follow me on Twitter @amyfeldman.




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