THE DIGITAL HEALTH* SECTOR AT A GLANCE
HMOs with >25 years of digitized EMRs
* Digital Health is a set of technology-based solutions that aim to have a direct impact on diagnosing, preventing, monitoring or treating a disease or condition.
675 Digital Health Companies
Examples of pivots:
SURE Universal provides a secure, personalized, end-to-end IoT home healthcare solution for remote diagnosis, monitoring and telehealth. The company’s platform delivers a complete, standard-compliant IoT software solution that provides system integrators with maximum interoperability and data security. The solution addresses home healthcare, home safety, security, smart homes and entertainment considerations.
Diagnostic Robotics temporary pivoted from a B2B to a B2G model to work directly with governments, helping to predict future COVID-19 outbreaks. The company worked with healthcare providers in Israel and abroad, sending out simple questionaries to the population, and used its AI algorithms to create COVID-19 heat maps for areas ranging from a specific neighborhood to entire cities. Now the company has returned to its core solution: clinical triage and prediction.
Vocalis Health is focused on developing voice analysis-based solutions for the detection of various health conditions. The company has developed a solution for 30-second COVID-19 detection which can be used alongside traditional biological tests. Vocalis Health has conducted pilots in a number of hospitals in the U.S., Israel and India.
Sanolla specializes in infrasound-enabling technology for the detection and monitoring of cardiopulmonary conditions, primarily for chronic patients. The company has developed an additional solution for the early detection of COVID-19.
New companies founded:
LessTests is a new company launched to focus on COVID-19 tests, offering single-step sample pooling for labs. The company has already received Israel Ministry of Health clearance and started partnerships in Israel and India.
Virusight Diagnostics is the result of a collaboration between NewSight Imaging, which develops sensors for machine vision, and Sheba Hospital. The company is the developer of a COVID-19 screening device that can diagnose COVID-19 in less than one second with 95% accuracy.
Zeppi is a floating robotic home communication device designed to help connect the elderly population with their families and caregivers.
Stability in total funding: fewer, yet larger rounds
Approximately 180 investors invested in the sector in 2020. Sixty-percent of the rounds involved at least one foreign investor, while dedicated Life Sciences investors increased their share to 34% of total investors.
Six new Digital Health-focused VCs were launched in 2020, including the following: Alive, a $150M mid- to late-stage MedTech fund with Leumi Partners as an anchor investor and Assuta and Maccabi as strategic partners, and Almeda Ventures, an early-stage HealthTech fund.
Existing VCs also launched new funds, including OTV (formerly Olive Tree Ventures) and Peregrine. Early-stage VC MizMaa, which has not previously focused on Digital Health, signed a strategic partnership agreement with leading global Digital Health VC 7Wires Ventures to invest in Israeli Digital Health companies.
SNC collaborated with Optum Ventures, an independent investment arm of Optum, a part of UnitedHealth Group with $600M under management.
"Israel is an incredible ecosystem for innovation in healthcare. There is high quality entrepreneurial, technical and clinical talent, along with an international mindset which helps to make Israel one of the most exciting startup ecosystems in the world. As a global VC investor, we look for forward to working with more members of the Israeli health tech ecosystem."
Funding has varied considerably between different subsectors. The leading three subsectors were Decision Support, Remote Monitoring, and Diagnostics.
Big leap in investments
Diagnostics companies raised $340M, or 44% of the total sector funding in 2020. This subsector stood out as investors were increasingly seeking affordable diagnostics solutions. Despite a high concentration of funding, the solutions were diverse and not limited to COVID-19-related applications.
Notable 2020 Investments (press logo for details):
Digital mini x-ray company Nano-X Vision received $105M in numerous rounds and eventually went public on the NASDAQ in August, raising $190M.
Funding, $m and as % of sector total
The effect of COVID-19 on the Israeli Digital Health sector
The need for new solutions led to increased interest in Israel’s Digital Health sector. The most sought-after solutions were those designed to help with the limitations and challenges of lockdown and social distancing, rather than solutions related directly to COVID-19 itself.
As was the case globally, the sector experienced strong interest in solutions related to remote care, including those required for diagnostics and telemedicine, such as point-of-care (POC) blood tests, home diagnostics and home care in general.
Companies with solutions related to COVID-19 attracted record-level funding
We identified startups that developed solutions relevant to COVID-19 and its associated effects and grouped them under the label of "CoronaTech".
The median round size of a CoronaTech companies in 2020 was $8M, almost double the median investment in the same companies in 2019, and $5M more compared to non-CoronaTech companies.
This sector includes companies offering a wide variety of direct and indirect solutions for coping with the COVID-19 situation, including vaccine development, drugs and tests; remote monitoring for patients and the general population; tracking and tracing technologies; and solutions dealing with the social and mental aspects of social distancing.
93% of all CoronaTech companies were founded before 2020, meaning that either their existing solutions turned out to be exceptionally relevant to the situation or they pivoted into CoronaTech or added CoronaTech solutions in 2020.
There are currently 293 companies with CoronaTech solutions, including 196 health-related and 137 from the Digital Health sector. Companies from the Digital Health sector are dominated by Decision Support, Diagnostics and Remote Monitoring, which represent 70% of the total.
Survey: a majority of surveyed startups flourished despite the pandemic
SNC conducted a survey* to learn about the pandemic’s effect on Israeli Digital Health startups:
Of the Israeli Digital Health startups that responded to the survey, 59% said that they had flourished in light of the pandemic, with 73% of this group offering remote care solutions. In addition, they said that recognizing the importance of access as it relates to remote care helped them get on the radar of potential partners and created additional business opportunities.
At the same time, startups whose solutions were outside the area of remote care or directed directly at COVID-19, such as solutions for pulmonary conditions, reported having a difficult year, as hospitals were less focused on non-COVID-related innovation. The same held true for non-COVID-19 related clinical trials.
*The survey was sent to all Israeli Digital Health startups the week of November 15, 2020, with 75 companies responding.
51% of the companies that reported flourishing due to the situation had a released product, as opposed to the 39% that said they were negatively affected.
61% of startups in the sector that flourished due to the situation either developed an additional solution or pivoted in response to the situation.
61% of the companies that flourished either already have regulatory approval or don’t need it.
Some startups reported that despite having had a negative effect on their current operations, the pandemic has improved healthcare providers’ awareness and attitudes regarding Digital Health tools in general, thereby increasing their potential opportunities.
A unifying feature of the companies that saw the greatest success in 2020 is that they all help to decentralize healthcare by making it available outside of hospitals and large clinics and by improving its quality and affordability. These solutions have the ability to be transformative, changing the way that healthcare is provided or offering totally new services that were not available previously. The COVID-19 pandemic has turned some previously nice-to-have solutions into must-have ones.
The leading solutions share a number of common features:
The leading solutions are heavily focused on technology, and on AI in particular. It has become so dominant that 95% of all funding in the leading subsectors in 2020 was in companies utilizing AI as a core technology.
For the sector as a whole, the share of funding raised by AI companies has grown every year. Many new Digital Health solutions are developed using AI from the beginning, while more mature companies are adding AI components as a next layer to their solutions.
Examples of companies that have added an AI layer:
TytoCare has added an AI-based decision support feature for physicians.
Blood diagnostics company MeMed is working on additional capabilities for solutions predicting patient deterioration.
Wearable vital signs monitoring company Biobeat now uses data it has collected in its AI-driven early-warning score system.
As patients were unable to access hospitals and clinics due to COVID-19 restrictions, they discovered new options for taking control of their personal healthcare needs, driving consumer demand for these solutions. Israel is generally known as a B2B ecosystem and Digital Health is not an exception, with 74% of the startups in the sector offering B2B solutions. However, there are a number of leading consumer startups in the country, with five of the 10 most well-funded Digital Health companies offering solutions for consumers as end clients (see table). These five companies have raised $612M combined in total accumulated funding, including $140M in 2020, or 19% of total sector funding.
Advanced Technology in B2C – The Most Well-Funded Digital Health Companies
Total Funding, $M
Note: B2C and B2B2C highlighted in blue
Examples of advanced technology in B2C:
Kai – The AI-based conversational coach launched in late 2019 and progressed well during the COVID-19 era. Originally B2C, the company is now working on a B2B2C model to sell to employers.
XR-Health – This VR-based digital therapeutics company develops a variety of applications ranging from physiotherapy to mental health.
Circles – Provides online support groups using a hybrid model of remote groups led by a real coach/counselor. This hybrid model is an important trend that has strengthened during the pandemic.
Playwork – This IoT physiotherapy company, initially targeting senior housing and rehabilitation facilities, has developed a new version of its product for home use for the direct B2C market.
Giant Leap – The company’s personalized child development assessment platform, initially targeting institutions such as schools, began to see direct interest from end users during the pandemic.
The Local Ecoystem as a Validation Site
The pandemic became a catalyst for more beta testing and deployment in Israel, as rapid deployment became crucial at the same that travel became impossible. This is a win-win situation for both local healthcare systems and digital health startups, and we expect to see more of this type of collaboration in the near future. All of the prerequisites are already in place, including many years of health data, strong research and technological expertise and existing innovation platforms.
The Pfizer COVID-19 vaccine is probably one of the strongest examples of Israel becoming a validation site for a global pharmaceutical company due to its digitalized health data infrastructure. The concentrated and fully digitalized Israeli healthcare system was able to reach out to relevant population groups extremely quickly, vaccinating two million people within just a couple of weeks. In addition, it was able to provide data insights to Pfizer and the WHO regarding vaccine efficiency and side effects.
Local players are showing greater interest in Israeli Digital Health:
The bio-convergence trend
The Israel Innovation Authority has identified bio-convergence, the intersection of Digital Health, computational biology, and AI, as a new growth engine for Israeli high tech, and is providing support programs to further develop this area. The goal of the bio-convergence initiative is to help advance AI-based computational technologies aimed at discovering personalized solutions and treatments.
The initiative includes the launch of the Bio-convergence Innovation Lab. Pfizer, AstraZeneca, Merck and Teva won a tender to become partners in the lab, which will receive a $9.9M government budget as well as additional funding from partners. Each startup participating in the lab project will receive approximately $1M in funding.
Unprecedented new interest in Israel from pharma giants
Following several years of relatively low innovation activity by global pharmaceutical companies in Israel, there was a dramatic increase in interest in 2020, with a number of new initiatives involving global pharmaceutical companies launched in the ecosystem. Among these initiatives are the following:
The Digital Health accelerator program PlayBeyondBio, launched by AstraZeneca with JVP and Margalit Startup City Community, is AstraZeneca's first foray into innovation activity in Israel. As the importance of real-world evidence grows for the pharmaceutical industry, AstraZeneca has a strong interest in Digital Health solutions that can help analyze patient data. This may be followed by innovation for core drug discovery, according to Ohad Goldberg, the president of AstraZeneca Israel.
In another important initiative, Israel’s largest HealthTech venture capital, aMoon, has launched the StarFinder Digital Innovation Lab, a joint early-stage Digital Health investment program with Roche. The three-year program is designed to accept nine companies (three per year) in different areas/subsectors. Program participants will receive funding, strategic mentoring, access to data and eventually access to customers.
According to Alexandra Vallon-Eberhard, Senior Director of Global Business Development at Roche Diagnostics:
"Israel’s healthcare system allows longitudinal medical data to be accessible across the patient journey for the benefit of research and development, particularly healthcare decision support solutions. We believe impactful synergies with Roche could be created for changing lives in the future.
SNC’s recent engagements with global pharmaceuticals:
In 2020, SNC collaborated with two of the world’s ten largest pharmaceutical companies on various Digital Health projects. While technically competitors, each company had a different offering and area of interest in the ecosystem.
The first company was looking to partner with Israeli startups through an open innovation model. SNC assisted senior management in mapping the landscape, understanding key stakeholders, and identifying initial partnerships and technologies to support the company's drug discovery teams.
The other company, Eli Lilly, is also operating through an open innovation model, collaborating with Digital Health technologies in the areas of diabetes, neuroscience, immunology and oncology with a focus on innovative delivery methods. SNC introduced the company to several startups that offer cutting-edge technology capable of providing solutions to the challenges at hand.
“At Lilly, our purpose is creating medicines that make life better for people around the world. We believe that combining today’s most advanced digital technologies with scientific innovation can lead to personalized and actionable insights for patients, new channels of engagement between patients and their health care providers, and improved self-management solutions – all of which can contribute to better health.”
– Rich Carter, Chief Digital Officer
ABOUT START-UP NATION CENTRAL
Start-Up Nation Central is an independent nonprofit organization that builds bridges to Israeli innovation. We connect business, government and NGO leaders from around the world to Israeli innovation through highly customized business engagements and through Start-Up Nation Finder – an easy-to-use, up-to-date, free online platform for discovering and connecting with thousands of relevant innovators.
We identify technological sectors with high growth potential and help them develop to maturity. We are currently focused on the Digital Health, AgriFood-tech and Industry 4.0 sectors, exposing them to global audiences, helping them develop practical tools, attracting investors and establishing and nurturing tech communities to increase collaboration, knowledge-sharing and skill expansion.
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Dataset amounts and definitions relating to Israeli innovation and entities are in accordance with those of Start-Up Nation Finder. Companies considered for this report were founded by Israelis and pursue R&D activities in Israel and are not service providers. This report organizes Israel’s Digital Health sector into seven subsectors. This division organizes the relevant companies into an inherently simplified classification. Some companies offer multifaceted technologies and therefore may be assigned to multiple subsectors. However, for the sake of identifying investment and technology trends, we associate each company with only one subsector that reﬂects the company’s primary focus. Figures representing the number of companies and investments in Israeli Digital Health and its subsectors are likewise exclusive.
Authorship and Editing
Lena Rogovin – Senior Digital Health Analyst, Sector Lead
Aviv Alper – Senior Director of Research
Meir Valman – Director of Research
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