Sound Businesses: Profiles of companies and business models we are keeping an eye on.
Diagnostic-imaging company Zebra Medical Vision combines the knowledge of images and the power of the cloud to read X-Ray, CT and MRI scans faster and more accurately than a human radiologist. Zebra is already saving lives in Israel, Europe and the U.S., and now it will attack a tuberculosis epidemic in Asia.
With $50 million from investors including Sun Microsystems founder Vinod Khosla and medical giant Johnson & Johnson, the AI-powered Israeli company uses deep learning from huge datasets of millions of records to train its algorithms to recognize abnormalities in medical scans, flagging patients in need of urgent treatment to overworked radiologists.
“In radiology, the accuracy with which a machine can read an MRI or a CT scan or an X-Ray is way better than a human can. Frankly, it’s sort of criminal to have radiologists doing this because in the process they are killing people,” Khosla told Medscape.
This summer, Zebra will start deploying its technology in partnership with Apollo Hospitals Group, India’s largest healthcare provider, to help tackle the tuberculosis epidemic.
“The Apollo Group treats 40 million people, but there are 1.1 billion people outside its network. Many of them live in rural areas and are deprived of medical expertise,” Zebra co-founder and CEO Eyal Gura said in an interview with Karma at the company’s headquarters in Shefayim, north of Tel Aviv. “With AI we can serve those rural areas with cloud-based diagnostic services – for TB screening or breast cancer screening, for example, things that sound obvious when you live in the western world next to a hospital. But half the world’s population can’t enjoy those benefits.”
Zebra aims to capture a slice of the fast-growing digital health market, which Accenture estimates will reach $6.6 billion by 2021, and save $150 billion for the U.S. healthcare economy alone by 2026. Zebra is just one of about 60 companies worldwide aiming to transform healthcare using artificial intelligence.
Gura believes few of his competitors can match Zebra’s ability to diagnose images of many conditions in all parts of the body. Many of the rivals are focused on a specific problem with a specific algorithm, while Zebra is building algorithms for a range of different pathologies, he said.
Zebra last month became the first company approved by the FDA to provide emergency triage for pneumothorax – a potentially fatal hole in the lung – based on chest X-Rays. FDA approval is pending for Zebra’s reading of head CTs to diagnose life-threatening intracranial hemorrhage.
“Pneumothorax is just the first and important milestone on our way towards a broad range of AI-based chest X-Ray applications, covering the most acute and life-threatening thoracic pathologies,” said Eli Goz, Zebra’s lead AI researcher for X-Ray products.
In Britain, Zebra’s EC-approved technology for diagnosing vertebral compression fractures is used successfully to catch overlooked conditions in patients at Oxford University Hospital. Vertebral compression fractures are estimated to cost the UK’s National Health Service about $2 billion a year, and the U.S. healthcare system more than $16 billion a year.
“Research has shown that radiologists miss up to 50% of vertebral fractures, since they are usually focused on looking for other features,” said Kassim Javaid, a fracture specialist at Oxford. “We believe that early detection of such fractures can yield both better care and significant healthcare cost savings.”
By mid-2020, 90% of Israel’s population will enjoy free access to Zebra’s diagnostic tools thanks to a grant from the Israel Innovation Authority. Announced in February, the cash will fund the deployment of the company’s technology to triage emergency cases in the country’s busiest ER at Ichilov Hospital in Tel Aviv, and for early detection of breast cancer, osteoporosis and heart disease via Maccabi and Clalit, two of the country’s largest healthcare providers.
“We have a vision of impacting 10 or 100 times more people than are currently being impacted by traditional medicine or healthcare,” Gura said. He is a serial Israeli entrepreneur who sold his digital-image start-up PicScout to Getty Images and his crowd-purchasing start-up The Gifts Project to eBay.
Khosla, who was Zebra’s initial investor, shared the company’s vision of first recreating medicine, and then creating profits.
“He had a very big outspoken thesis around how algorithms will eventually replace most of what medical staff were doing. He wasn’t about business models or reimbursement. He was about disrupting and creating something new. We connected on this level,” Gura said.
The rollout in India, which will cost $4.9 million, is 50% funded by grants from the India-Israel Industrial R&D and Technological Innovation Fund sponsored by both governments.
“When it comes to health, the promise of AI to provide access and improve outcomes in very intriguing. There is a critical need to provide good healthcare access in remote and rural communities, and we believe this initiative will allow us the opportunity to make significant advances in this area,” said Sangita Reddy, Apollo Hospitals’ joint managing director.
Gura said it’s well worth his company funding its share of the project.
“We think it’s a good investment,” he said. “If we are able to scale in India, it’s going to be the first or second healthcare market in the world in 10 years. Partnering with a group like Apollo Hospitals is the right first step.”
Zebra’s partners worldwide have access to over 10,000 hospitals, Gura said. “We’re hoping to grow into hundreds or thousands of those hospitals over the next few years.”
The possibilities in such large markets allow Zebra’s funders to believe they will eventually see good returns.
“So far, all of our investors are pretty much driven by the same agenda of making an impact while making a profit,” Gura said. “None of them is a regular non-profit type of investor that just wants to deploy money for good causes. All of them think it can be a big business and create nice returns. But all of them also have on their agenda to make an impact.”
Matthew Kalman reports on Middle East tech, business and the environment from Jerusalem.