Author: admin

04 Feb 2023

Curated GI articles February 3rd, 2023: FDA approves neurostimulator for incontinence | Study: Virtual GI care saves $10k per patient

Curated GI articles February 3rd, 2023:
FDA approves neurostimulator for incontinence | Study: Virtual GI care saves $10k per patient
Podcast: Robbie Allen, CEO of One GI (Becker’s GI & Endoscopy)
Robbie Allen (CEO of One GI) discusses the future of physician employment in the midst of dwindling numbers of independent physician groups, different generational perspectives on work, and more.
FDA approves 4th-generation neurostimulator for fecal incontinence, overactive bladder (Healio)
The FDA has approved Axonics Inc’s fourth-generation R20 rechargeable sacral neuromodulation system for bladder and bowel dysfunction.
Clinical Trial Results Demonstrate Oshi Health’s Multidisciplinary GI Care Improves Patient Outcomes with Savings Greater than $10,000 Per Patient Within 6 Months (PR Web)
The findings are important as digestive disorders are very common and have a high economic burden, affecting more than 70 million people in the U.S.
The future of GI (MDedge)
Judy A. Trieu, MD, MPH, the Editor-in-Chief and Advanced Endoscopy Fellow of the Division of Gastroenterology & Hepatology at the University of North Carolina at Chapel Hill, gives an overview of the articles regarding the future of GI.
Can AI Conquer the Late-Shift Dip in Colonoscopy Quality? (Medscape)
New research confirms that colonoscopies conducted later in an endoscopist’s shift are associated with a decline in adenoma detection and demonstrates that AI can help eliminate the problem.
Private Equity and Digital Health in 2023: Policy Updates and Trends to Watch (JD Supra)
The following serves as a broad overview of recent policy updates and areas of opportunity in 2023.
Salve Lucrum: The Existential Threat of Greed in US Health Care (JAMA Network)
The grip of financial self-interest in US health care is becoming a stranglehold, with dangerous and pervasive consequences.
Gut-Directed Hypnotherapy App Improves IBS Symptoms (GI & Endoscopy News)
A gut-directed hypnotherapy program conducted via a downloadable app was shown to improve GI symptoms —and to a degree that is similar to that seen in face-to-face therapy.
Ayble Health Recognized as the First and Only Gastroenterology Company to Achieve Certification from the Validation Institute for IBS and IBD Patient Outcomes (Ayble Health)
Ayble Health is tenacious in its pursuit to transform the standard of care for GI patients. Sam Jactel (CEO, Ayble Health) was recently interviewed on The Scope Forward Show.
Why are so many physicians quitting medicine? The real reasons revealed (KevinMD)
What will the health care system do with so many physicians leaving medicine? This article reviews two reasons physicians leave their current roles for something else.
Salvo Health & Gemelli Biotech partner to offer cutting-edge diagnostic testing for IBS and SIBO across 29 states (Salvo Health)
The partnership will provide access to advanced breath testing and IBS blood testing not generally available in most doctor’s offices.
Doctors, Get Ready for Your AI Assistants (WIRED)
Hospitals have begun using machine learning to help analyze and collect images, and the medical applications are endless.
10 gastroenterologists in the headlines (Becker’s GI & Endoscopy)
A compilation of gastroenterologists who have made news headlines, by Becker’s Healthcare.
Income Could Plunge for Out-of-Network Doctors (Medscape)
Out-of-network (OON) status has been financially advantageous for doctors, but in recent years, insurers have been making it harder to be OON.
Minimally invasive endoscopic therapies for gastro-oesophageal reflux disease (BMJ)
In recent years, several minimally invasive antireflux endoscopic therapies (ARET) have been developed which may play a role in bridging the unmet therapeutic gap.
New Treatment Recommendations for Early-Onset CRC (Medscape)
An international group of physicians has issued consensus recommendations for the diagnosis and management of patients with early-onset colorectal cancer (eoCRC).
Assessment of the Role of Artificial Intelligence in the Association Between Time of Day and Colonoscopy Quality (JAMA Network)
The findings suggest AI systems may be a potential tool for minimizing time-related degradation of colonoscopy quality.
‘Evidence supports’ de-escalating combination therapy in patients with IBD after 1 year (Healio)
Providers should consider de-escalating combination therapy with immunomodulators to monotherapy after 1 year in patients with inflammatory bowel disease, according to a presenter at the Crohn’s and Colitis Congress.

Register: 2023 AGA Tech Summit (AGA)

Young, gifted and Black: 3 GIs making an impact (AGA)

Virginia lawmakers push for greater coverage of colon cancer screening costs (Becker’s GI & Endoscopy)

It’s ‘telehealth vs. no care’: Doctors say Congress risks leaving patients vulnerable (News Medical)

‘I Cry but No One Cares’: Physician Burnout & Depression Report 2023 (Medscape)

4 gastroenterology, endoscopy facility openings in 2 weeks (Becker’s GI & Endoscopy)

Video: Medical Uses of ChatGPT (The Medical Futurist)

Patients with IBD, ‘higher social vulnerability’ inadequately screened for mental health (Healio)

Combination biologic therapy for ulcerative colitis (The Lancet GI & Hepatology)

Predicting Barrett’s Esophagus, Esophageal Adenocarcinoma 5 Years Before Diagnosis (GI & Endoscopy News)

Videos: Interviews with GI Leaders  (Scope Forward Show/NextServices)

COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
30 Jan 2023

Curated GI articles January 27th, 2023: Connecticut GI Joins GI Alliance | ASC colonoscopy 2023 reimbursements

Curated GI articles January 27th, 2023:
Connecticut GI Joins GI Alliance | ASC colonoscopy 2023 reimbursements
GI Alliance Expands to East Coast with Connecticut GI Partnership (PR Newswire)
GI Alliance has announced a partnership with Connecticut GI, expanding GI Alliance’s presence into the Northeast and its 15th state.
Broadening Horizons: Why Gastroenterologists Should Consider a Career in Obesity Medicine
(Springer Nature)
In this paper, we will make the case for choosing a career in obesity medicine for GI fellows and practitioners.
Tips for getting involved with industry (MDedge)
This article offers a variety of ways that gastroenterologists can engage with the industry to achieve a mutually beneficial relationship.
EndoSound® Receives Investment From AGA’s GI Opportunity Fund (Business Wire)
EndoSound was granted Food and Drug Administration (FDA) Breakthrough Device designation in July 2021.
Is It Time for a More Personalized Approach to CRC Screening? (Medscape)
A new study confirms that the 10-year screening colonoscopy interval is safe and could even be extended in some adults at average risk for CRC.
How colonoscopy reimbursement is expected to change for ASCs in 2023 (Becker’s GI & Endoscopy)
Medicare ASC payments for colonoscopies with lesion removals and colonoscopies and biopsies are expected to increase in 2023, according to VMG Health’s “ASCs in 2022: A Year in Review” report.
Computer-Assisted Detection and Diagnosis Can Improve ADR, Reduce Costs (GI & Endoscopy News)
The incorporation of computer-assisted detection and diagnosis in colonoscopy can improve ADR. But can technology replace endoscopist training?
Should you sell your medical practice to a private equity group? (Medical Economics)
Healthcare practitioners are feeling the squeeze. Does staying small make sense for your practice anymore?
Sanofi, CytoReason expand AI deal into IBD (Pharmaphorum)
Tech company CytoReason has announced it has signed a multi-year, multimillion dollar deal with Sanofi to deliver AI for drug discovery and development in the field of IBD.
Smartwatches, wearable technology ‘may hold promise’ to identify, predict IBD flare (Healio)
Wrist-horn smart watches and wearable technology that monitors heart rate variability may help identify and predict flares of IBD.
Michigan Medicine gastroenterologist no longer works at university amid falsified data allegations (Becker’s GI & Endoscopy)
Chung Owyang, MD, a former gastroenterology researcher at Ann Arbor-based Michigan Medicine allegedly falsified data in multiple publications.
For This Physician, Retirement Is An Opportunity (Next Avenue)
A retired gastroenterologist tells of being a mentor to pre-med students, and what he and the students have gained from their discussions about the profession.
Is Food Sensitivity Testing a Scam? (NY Times)
Food sensitivity tests promise to supply answers. But do these tests work? Here’s what the experts have to say.
The Impact of Cascading Accountability on Specialty Practices: Time for a Nested Solution (CGH Journal)
Understand the perspective of the authors on the direction gastroenterology needs to take and why it cannot be a standalone solution, but rather needs to be integrated within other solutions.
Only Half of Folks With Stool Test Positive for Colon Cancer Get Follow-Up Colonoscopy (The Independent)
Many people undergo a stool test to screen for colon cancer but a new study finds too few follow up with a colonoscopy when that test warns of a possible cancer.
AI doctor will see you now: ChatGPT takes medical exams (Cyber News)
A group of researchers had the viral chatbot take the same US medical licensing exams as aspiring doctors. It performed “comfortably within the passing range,” they said.
Can Tech Giants Take Over Healthcare? (The Medical Futurist)
Could tech giants just take over healthcare? Here is a list of relevant factors you need to consider when thinking about what will happen in the next decade.
5 IBD updates from the 2023 Crohn’s & Colitis Congress® (AGA)
Less restrictive diets for Crohn’s disease, preoperative use of biologics, ultrasounds to monitor UC and more.

Register: 2023 AGA Tech Summit (AGA)

SF Interview- Jactel: “Being patient centered is different than being patient driven” (NextServices)

Young doctors are earning more. Will it be enough? (MDLinx)

Microbiome startup cuts 95% of remaining staff in 3rd layoff in 9 months (Boston Business Journal)

AGA risk assessment tool aids patient, physician decision-making for Crohn’s therapy (Healio)

Geneoscopy completes PMA filing for colorectal cancer home test (BioWorld)

FDA approves drug for treatment-resistant metastatic colorectal cancer (Becker’s GI & Endoscopy)

Virginia lawmakers push to cover cancer screenings costs, honors late local delegate (WSET)

Pediatric Gastroenterology: Physician Burnout (Physician’s Weekly)

Gastroenterology and Urology for Certified Medical Scribe Professionals (PR Newswire)

Videos: Interviews with GI Leaders  (Scope Forward Show/NextServices)in GI

COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
21 Jan 2023

Curated GI articles January 20th, 2023: CellMax blood test for CRC | One GI expands in Virginia | Racial disparities in IBD

Curated GI articles January 20th, 2023:
CellMax blood test for CRC | One GI expands in Virginia | Racial disparities in IBD
Gastroenterology gains 1,128 physicians over 5 years (Becker’s GI & Endoscopy)
Gastroenterology gained 1,128 active physicians from 2016 to 2021, according to the Association of American Medical College’s “Physician Specialty Data Report.”
One GI® Expands Virginia Footprint Again (PR Newswire)
One GI®, the Home for Independent Gastroenterology, expands Virginia footprint again with Gastroenterology Associates, PC, partnership.
Healthcare Private Equity Down But Not Out, Report Finds (RevCycleIntelligence)
2022 was the second biggest year on record for healthcare private equity despite an uncertain and inflationary market hampering activity by the end of the year.
CellMax Life Announces Positive Results From Prospective Multisite Study of Novel Blood Test to Detect Colorectal Cancer and Pre-Cancer (PR Web)
Data shows 92% sensitivity for colorectal cancer and 55% sensitivity for precancerous advanced adenomas at 91% specificity.
Focus on six key areas for successful physician partnerships (Physicians Practice)
Entering a physicians partnership is not a process that should be rushed through nor taken lightly.
Unclogging the Pipes of Your GI Practice‍ (Telebelly)
Russ Arjal MD (Co-founder and CMO, Telebelly Health) provides insights to improve GI care for patients
America’s physicians are getting older, women are gaining ground, and more data on doctors (Chief Healthcare Executive)
The Association of the American Medical Colleges released a report that offers more insight on the nation’s physician workforce.
At-home bowel cancer tests could help reduce colonoscopies (EurekAlert)
Screening for bowel cancer using at-home faecal immunochemical tests could help to reduce the frequency of colonoscopies for some at above-average risk individuals.
Blood test could help predict which patients with colon cancer need chemotherapy after surgery: Study (ABC News)
A blood test under study may soon be able to help many patients with colon cancer decide whether they need chemotherapy after surgery, or if they can safely skip it.
Digital Health Funding Slows In 2022: Is The Hype Fading Or Is It A Temporary Setback ? (Workweek)
While 2022’s total digital health funding disappointed many, it was anything but unexpected.
Regenstrief Institute research scientists study online colorectal cancer risk calculators (EurekAlert)
Regenstrief Institute and Indiana University School of Medicine research scientists have conducted a study of online colorectal cancer risk calculators.
FIT DNA Screening Results Have Multiple Implications for Follow-up Colonoscopy (GI & Endoscopy News)
Colonoscopies performed after abnormal fecal immunochemical DNA tests are associated with greater detection of lesions, longer withdrawal times and recommendations for shorter intervals.
Top 100 hospitals for gastrointestinal care by state, per Healthgrades (Becker’s GI & Endoscopy)
A list of top hospitals for gastrointestinal care listed by Healthgrades in 2023 by state.
MedPAC asks Congress to increase physician payments (Healio)
The Medicare Payment Advisory Commission, or MedPAC, has recently voted to recommend that Congress increase 2024 Medicare payments for physicians and other health services.
Racial Disparities Seen in Use of IBD Medical Therapy (Pharmacy Practice News)
Black patients with inflammatory bowel disease are less likely to be treated with immunomodulator or biologic therapies than white IBD patients, according to a recent study in a large U.S. cohort.
Advanced colorectal neoplasia prevalence remains low 10 years after negative colonoscopy (Healio)
Screening colonoscopy has been shown to reduce colorectal cancer incidence and mortality by enabling detection and removal of precancerous lesions.
Scant Evidence for Proton Pump Inhibitor Role in Gastric Cancer (Medscape)
The available evidence suggests that proton pump inhibitors (PPIs) do not cause gastric cancer, researchers say.
Helping your patients with NAFLD lose weight (AGA)
Hear key takeaways from AGA’s Clinical Practice Update on NAFLD management.

More Hot headlines in GI

Register: 2023 AGA TeRegister: 2023 AGA Tech Summit (AGA)

SF Interview- Jactel: “Being patient centered is different than being patient driven” (NextServices)

Oshi Health Adds Distinguished Physician-Scientist and Upcoming AGA President Dr. Maria T. Abreu to Medical Advisory Board (PR Web)

Physician Sues AMA for Defamation Over 2022 Election Controversy (Medscape)

‘Clinical paradox’? Bariatric surgery may protect from GI cancers (MDedge)

Novel IgG-Based Elimination Diet Shown to Improve IBS Outcomes (GI & Endoscopy News)

EndoTheia Inc. Announces FDA Breakthrough Device Designation for Technology to Improve Endoscopic Surgery (BusinessWire)

Digesting 2022 and looking forward to 2023 in IBD therapeutics (Healio)

Videos: Interviews with GI Leaders  (Scope Forward Show/NextServices)ch Summit (AGA)

A 2022 Look Back: Increasing GI Expertise with 19 New Providers (MNGI Digestive Health)

Biomerica Appoints Mayo Clinic Gastroenterologist, Dr. Brian E. Lacy, to the Company’s Scientific Advisory Board (Globe Newswire)

Q&A: Gravity’s role in IBS pathogenesis, symptoms: A new hypothesis (Healio)

Dayton Gastroenterology, LLC., Now Incorporates First Artificial Intelligence System for Enhanced Colonoscopy Screenings (PR Newswire)

Longitudinal gut microbial signals are associated with weight loss: insights from a digital therapeutics program (MedRxiv)

Immune checkpoint inhibitor–related gastrointestinal adverse events (MDedge)

The effect of active video games on cognitive functioning in clinical and non-clinical populations: A meta-analysis of randomized controlled trials (Science Direct)

AGA Offers Key Guidance on Managing Subepithelial GI Lesions (Medscape)

At J.P. Morgan healthcare conference, Exact Sciences CEO describes pivotal meeting for Cologuard development (Lab Pulse)

Videos: Interviews with GI Leaders  (Scope Forward Show/NextServices)

COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
15 Jan 2023

Curated GI articles January 13th, 2023: Geneoscopy CRC test shows 94% sensitivity | ModifyHealth raises $10M

Curated GI articles January 13th, 2023:
Geneoscopy CRC test shows 94% sensitivity | ModifyHealth raises $10M
Geneoscopy’s Noninvasive Colorectal Cancer Screening Test Demonstrates High Sensitivity and Specificity in Large Pivotal Clinical Trial (PR Newswire)
The CRC-PREVENT trial included 8,289 individuals with diverse racial, ethnic, and socioeconomic backgrounds across more than 2,900 zip codes in all lower 48 states.
SF Interview- Jactel: “Being patient centered is different than being patient driven” (NextServices)
In this episode, Praveen Suthrum speaks with Sam Jactel (CEO, Ayble Health) about his experience transitioning from being a GI patient to leading a digital health startup, the challenges facing the industry. Tune in to gain insights on his journey and more.
Private equity changes workforce stability in physician-owned medical practices (Medical Xpress)
The findings are the latest in a line of research to suggest private equity firms are increasing pressure to maximize profits.
ModifyHealth Secures $10 Million Series B Investment to Fuel Growing Demand for Its Medically Tailored Meals and Food as Medicine Platform (PR Newswire)
Diet-related chronic conditions continue to rise, accounting for nearly 75% of all health care dollars spent in the US.
Physician Growth Partners advises Gastroenterology Associates in transaction with One GI (EIN Newswire)
The transaction bolsters One GI’s existing Northern Virginia footprint and will accelerate their growth in the Mid-Atlantic market.
Unio Health Partners announces a partnership with inSite Digestive Health Care (PR Newswire)
Unio’s partnership with inSite represents a significant expansion of its gastroenterology business and more than doubles the size of the platform.
Colonoscopy Prep Retail Website Breach Festered for Years (Bank Info Security)
Captify Health, a colonoscopy prep-focused management services company, notified about 244,300 patients that their personal information may have been compromised during a data breach.
Vivante Health Adds Cognitive Behavioral Therapy Digital Therapeutic to GIThrive Digestive Health Platform (Vivante Health)
The new feature, called IThrive™, is the first CBT solution to be integrated into a comprehensive digestive health platform that has been proven to reduce healthcare spend and improve participants’ quality of life.
‘Spread the wealth,’ utilize team-based care to combat growing GI provider shortage (Healio)
The phenomenon of people retiring early because of burnout or leaving their institutions to work in a different field is detailed in the cover story.
Proximal ADR could become important new quality metric (MDedge)
Dr. Kosinski and colleagues analyzed retrospective claims data from all colonoscopies performed between 2016-2018.
Key Insights on Diagnostic Tools for NASH (GI Insights)
Dr. Charles Turck joins Dr. Kenneth Cusi to dive into diagnostic guidelines and share the latest updates on these tools.
The Coming Collapse of the U.S. Health Care System (TIME)
The massive financial drain imposed by staff shortages and use of locums has led to many health care facilities reaching the point of financial instability.
American College of Gastroenterology Guidelines Update: Diagnosis and Management of Celiac Disease (ACG)
This guideline presents an update to the 2013 ACG Guideline on the Diagnosis and Management of Celiac Disease with updated recommendations for the evaluation and management of patients with celiac disease.
What The FTC’s Proposed Ban on Noncompete Agreements Could Mean for Physicians, Other Clinicians (Medscape)
Many doctors would like to see noncompete agreements vanish, but some physicians still favor them.
John Carethers (President, AGA): Advice to build your career (AGA)
In this episode Dr. John Carethers, the current AGA President discusses career advice and about his important 80/20 rule in decision-making.
Digital health needs to prove its impact to providers, or go the way of the buffalo (Medical Economics)
As a barometer of the digital landscape, HLTH showed the digital health community must cut through the hype and start delivering better tools to physicians and patients.
Colonoscopies save lives. Why did a trial suggest they might not? (Nature)
A major clinical study raised questions about one of the most celebrated cancer-screening procedures available, but a close look at the data tells a different story.
Capital Digestive Care Announces Three Key Executive Leadership Changes (Globe Newswire)
The company’s board of directors has elected Dr. Roderick Kreisberg to be its president and chief operating officer and Dr. Dan Neumann to be its president and chief strategy officer.

More Hot headlines in GI

Register: 2023 AGA Tech Summit (AGA)

A 2022 Look Back: Increasing GI Expertise with 19 New Providers (MNGI Digestive Health)

Biomerica Appoints Mayo Clinic Gastroenterologist, Dr. Brian E. Lacy, to the Company’s Scientific Advisory Board (Globe Newswire)

Q&A: Gravity’s role in IBS pathogenesis, symptoms: A new hypothesis (Healio)

Dayton Gastroenterology, LLC., Now Incorporates First Artificial Intelligence System for Enhanced Colonoscopy Screenings (PR Newswire)

Longitudinal gut microbial signals are associated with weight loss: insights from a digital therapeutics program (MedRxiv)

Immune checkpoint inhibitor–related gastrointestinal adverse events (MDedge)

The effect of active video games on cognitive functioning in clinical and non-clinical populations: A meta-analysis of randomized controlled trials (Science Direct)

AGA Offers Key Guidance on Managing Subepithelial GI Lesions (Medscape)

At J.P. Morgan healthcare conference, Exact Sciences CEO describes pivotal meeting for Cologuard development (Lab Pulse)

Videos: Interviews with GI Leaders  (Scope Forward Show/NextServices)

COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
13 Jan 2023

Sam Jactel, CEO of Ayble Health: “Being patient centered is different than being patient driven”

Sam Jactel, CEO of Ayble Health:
“Being patient centered is different than being patient driven”
At the end of the interview, Sam Jactel, GI patient turned CEO talks about Thomas Nagel the philosopher. In a paper from 1974, Nagel famously asked us to contemplate “What is it like to be a bat?” He suggested that you may be able to study the behavior of a bat but you can never really know what it’s like to be one.
Sam takes that analogy to his own GI condition. He was tired of looking for answers within the industry. He was tired of not being seen or heard. And he ended up figuring out a solution that worked for him. Then he thought why not help other patients like him. That prompted him to go from being the CEO of his own condition to becoming the founder and CEO of Ayble Health. This digital GI startup has raised $4.6 million from investors.
Watch this incredible interview. It’s a sign of the times. Expect more patients to become digital healthcare providers because the industry isn’t stepping up enough.
◘  From being a patient to becoming a CEO: The story behind starting up Ayble Health
◘  What is really missing in the GI industry?
◘  “The needs of the patients are either filtered or not heard”
◘  “The challenge that I have with GI and healthcare, in general, is that…”
◘  “Being patient-centered is different than being patient-driven”
◘  “With the tools that we have at our disposal, we are not driving optimal outcomes for patients like myself”
◘  “There aren’t even enough GIs to meet demand”
◘  Ayble Health raised $4.6 million. What triggered investor interest?
◘   The business model
◘  “We are part of the UCSF Rosenman Institute ADAPT program”
◘  The startup’s payment model
◘  Is the use of AI and machine learning really necessary?
◘  Is there a need for more and more digital GI companies?
◘  “We want patients to be seen”
◘  The future of GI & healthcare
◘  “I think that there’s too big of a gap currently between the claims that companies make in digital health and the evidence that supports it”

The Transcribed Interview:


Praveen Suthrum: Sam Jactel, founder, and CEO of Ayble Health. Welcome to The Scope Forward Show. I’m really looking forward to this conversation. This is one of the only times that I’m interviewing a patient who’s turned CEO, so really glad to have you. Welcome.
Sam Jactel:  It’s a pleasure to be here and really excited to be part of this long time listener, first time caller kind of thing. Really excited to have this conversation. And thank you to the audience also for their interest in what we’re building, how we’re building it, and really looking forward to the conversation.
Praveen Suthrum: Excellent. Sam, congratulations to you and your team for raising $4.6 million, and it’s a fantastic start. It is very reassuring for the industry and for digital GI that this space is growing, and it’s going to bloom in the coming years, and it’s very telling that you’re doing so in the IBS and IBD space. So, again, congratulations to you and your team.
Let me first start by asking you what the back story is here. How did you get started, and what is the story behind the name Ayble health?
Sam Jactel:  Happy to do that. Well, you know, I think at the end of the day, the story of Ayble is my own story. So I’ve been a GI patient for about ten years. I was diagnosed with ulcerative colitis, and  I’ve lived with that, and it’s not been the most linear journey, so to speak, and I think a lot of patients experience the same thing. But for me, I was diagnosed back in about 2014, and I was actually misdiagnosed a couple times before I got my final diagnosis. And over the past, you know, 8-9-10 years, I have seen five different gastroenterologists at some of the world’s best academic medical centers. I have played around with half a dozen different drugs, oral or not, over the counter supplements, all those kinds of things to find a cocktail that worked for me.
And despite having access to the best care that I was able to get my hands on and to be able to afford it, which is not the case for a lot of people in the United States, I think we make those assumptions. I still fell out of remission. I had four significant flares in the last eight years, and I couldn’t live like that anymore. And one of the things that I realized was that we were only, or I as a patient was only really getting treated as part of a person right of going to the clinic. The drugs were available, certainly, but not always effective alone, and the diagnostics were there and all those kinds of things. But the second I walked out of the clinic; I didn’t have any support for any of the evidence based interventions that my physicians were recommending to me. And those things were things like elimination diets or just dietary interventions generally, things like mental health support and cognitive behavioral therapy or being able to see a GI psychologist. And the best I ever got was a pamphlet and instructions to go figure that stuff out on my own. That just didn’t seem like it was good enough. And we were missing an opportunity in the space to use the new technology that exists out there, right, the machine learning, the predictive artificial intelligence, and just generalized technical tools to reduce the cognitive burden on the patient and improve the likelihood that I was going to get to remission.
And so that was kind of our core thesis. And the inception of the company was in very early 2020. I had my most recent pretty big flare and I was bedridden, and I just sat there and I said, I can’t do this anymore. And what I ended up doing was kind of working with group of researchers at Massachusetts General Hospital, Brigham and Women’s, Northwestern, and building out essentially a personalized nutrition program that worked for me and that I realized I could systematize and standardize and expand upon that could potentially also help others. And so we’ve been around since 2020 and for two and a half years we have been in the clinic running clinical research on that approach.
And so our precision nutrition program, which is kind of our flagship program, is built on 20 years of research in the space and the intersection between diet and IBS and IBD, as well as two and a half years. Of our own primary clinical research now published in Gastroenterology Inflammatory Bowel Diseases and most recently clinical and translational Gastro Neurology and are now taking that. And some of the funding is going to the commercialization of this novel machine learning guided precision nutrition program for folks like myself. But at the end of the day, to answer your question, I solved my own problem and realized that maybe it could help others. And that was, I think, the inception of where we came from.
Praveen Suthrum: Let me ask very fundamental question before we get into the company stuff and the business stuff and all that, when you experience GI as an industry, as a patient, you went in and out of clinics, met different gastroenterologists and so on, what’s missing in the industry? You touched upon it. But I want to touch on the pain a little bit. If you don’t mind, what really missing that caused you a great deal of discomfort and made you wonder that something is really off with our system.
Sam Jactel: How long do you have, my friend? Look, I think there’s a lot that’s going really well in the space. So I serve also on the congressionally directed medical research program as a patient reviewer for IBD. And I’m seeing a lot of amazing research that’s being done. There are new drugs, there are new approaches to team-based care for GI. And I think that folks in the space coming around and it’s a growing ecosystem that is evolving and doing better.
I think that the problem that I have is not maybe necessarily a GI problem. I think it’s just a healthcare issue. And I think the healthcare issue and something that I’m very passionate about is that healthcare is the only market where the end user doesn’t really have a voice. Here’s what I mean by that. So if you are a consumer of shoes, right, you will go and you’ll go to your store and you’ll purchase the pair of Nikes that you like and Nike will take that and say people are voting with their dollars. People like the gray shoes with the red stripe and I’m going to make more of those because that’s what people want and that’s what people need. And in health care there is no real direct way for someone like myself to vote with my dollars. And so what ends up happening is that the needs of the patient are either filtered or not heard.
And by that I mean the need of the patient is either filtered through the GI. The GI then gets to the pharma company, to the health system, to the insurer, and it’s like a game of telephone. It gets distorted. And I think the challenge that I have with GI and with healthcare in general, is that what then happens is that the companies that are building in the space, right, the ones that are innovative and putting tons and tons of dollars behind it. Are the health systems, are the insurers? Are the employers making those decisions with assumptions around where those patients are and what they actually need? And I think at the end of the day, we talk a lot about patient centricity. But unless you are patient, there’s always that little gap. I think that unless you live with it everyday, I don’t think you can make assumptions about what it’s like to live with it. And that’s where I think you see a lot of the statistics that are kind of shocking to people about what it’s like to suffer in that silence, right?
These conditions are taboo. Like we don’t like to talk about poop. I certainly didn’t. And so patients like myself just sit around there and we are unproductive at work. We are uncomfortable. There’s some really interesting statistics out there that just illustrate this and shock a lot of people like that. Patients like myself are willing to give up 15 years of our remaining life expectancy for an immediate cure today, that doesn’t exist. That’s like 20% of someone’s lifespan. That acute need and what it’s like to live with the condition, but also work in the environment of siloed places, of being essentially the CEO of your own condition because no one’s doing it for you. And I’ve had to do that.  Right? And you see, patients are incredibly resourceful. You have people building their own Excel models, people writing things in notebooks, gathering reams and reams of information so that they can problem solve for themselves in an environment that is not surrounding that patient. And that’s like a big piece to me, kind of in conclusion, is that being patient centered is different than being patient driven. And patients being founders, I think, is something that I’m really excited about, that we’re seeing in this space as well as other spaces.
Those are a couple of the observations that I’ve found and that I’ve lived with, and I figured, why not give it a shot? I’ve lived with it ten years of market research. There’s an opportunity to change the industry and the way that we think about it. By putting the patient as the driver, not as the passenger.
Praveen Suthrum: You know, Sam, my friends and colleagues in private practice are going to say, look, you know, you’re smart, you’re a biology major, you’ve done your MBA from Kellogg, and you have all these resources to put all this together and pay for diet, pay for drugs, and so on. But look, in our industry, we are driven based on what the insurance company pays. And so it’s managed care that is ruling. So who’s going to pay for all this food stuff? It sounds good. Who’s going to pay for it?
Sam Jactel: Yeah. And I think the core to this is, to me, there’s a trend into value based care.  Right? There’s a trend into at the end of the day, I think financial drivers are connected to outcomes drivers. I think the reality is, currently with the tools that we have at our disposal right now, we are not driving optimal outcomes for patients like myself. And the reason why is because we don’t have the tools. Right? And so one of the things that is really exciting about the way that we’re positioning ourselves is that we’re not disintermediating the physician at all. We want to keep you in the driver’s seat, and we want to be positioned as another tool in the physician’s toolbox to treat that patient. I’m also very empathetic, right? Like, you don’t have a lot of time talking to a patient. You also have not spent a huge amount of your medical career learning about nutrition, learning about mental health. You’re not an expert in that field. We also know that, like GI psychologists and GI specialized dietitians, there just aren’t enough to meet demand. There aren’t even enough GIs to meet demand. And so in that environment, we need to use technology to extend the care that a physician is able to provide to a patient.  Right? That’s the Hippocratic oath, right? That’s really important.
The other piece to it is if you can do that together as a holistic approach to care, you drive better outcomes and that drives cost down, but also make sure an ecosystem of GI as a treatment industry is long term sustainable. And I think that’s really important.  Right. We need to drive to those outcomes. And I think if we are only using a couple of tools and not all of them.
Praveen Suthrum: Excellent. Let’s talk a little bit more about the company. So what is the operational model and how do you plan to get paid? And why did investors choose to invest the money that they did in Ayble Health?
Sam Jactel: Yeah, it’s an exciting place to be. So very concretely. Ayble is a precision health platform for folks with gastrointestinal conditions, right? And I use the term precision health on purpose in the space. You’re probably familiar with precision medicine, right? You take a lot of variables from an individual that hopefully you can then use to predict what drug works best for that person. What about everything beyond the pill? And so we have built as a comprehensive ecosystem of care beyond the pill. And it’s built on the largest GI behavioral health database in the world. And in a way where we’re using machine learning and predictive AI to essentially gather a bunch of that data, continue to use it, so that eventually we’ll be in a situation where we can be able to predict for that individual what the right pathway through diet and through mental health will generate the most optimal outcomes. In addition to the pill.  Right. Not as a replacement. And so that’s kind of the ecosystem that we built.
Now, our go to market strategy is very similar to some of those companies that are category defining in other places, Headspace Health and a few others. And what it is, is essentially a B to C to B business model. One of the things that’s really exciting is that because we’ve been patients, we know where they are and we are going direct to consumer on purpose to be able to have that individual find evidence based resources in addition to the work that they’re currently doing in the clinic and then transitioning that into the enterprise. And so we sell through gastroenterologists and providers, primary care groups as well as that extra tool in that toolbox. And then of course through employers and insurers who are looking to drive down the claims volumes and drive down the per capita claims cost for patients like me who are incredibly expensive because we’re incredibly sick, that’s the kind of approach that we’re taking. But it’s very different. We’re not a virtual, like a telehealth platform right? We’ve kind of built out a digital therapeutic. We’ve wrapped around with hands on care, with a nutritionist and a health coach and a dietitian. And then we have last mile nutrition tools that allow us to suggest and find food products for someone to be that are compatible with their diet. What if you can’t eat onions? That’s hard enough, right? Alliums are poorly digested for most folks anyways, but it’s in everything. That’s why food tastes good, right? What if you’re also halal and you want to eat low sodium for other health reasons and you want to eat organic? Like, how do you do that? And so we built out this database of grocery store items, about 95% coverage across the United States. And we can filter for those foods that are compatible and not compatible for you, as well as pushing you recipes. And so really trying to wrap someone around with that full end to end support, not just leaving them with a recommendation and then still having them be at their own devices, but really combining end to end for them. To change the way they buy, change the way they cook, change the way they eat, and therefore feel good and adhere for the long term.
Praveen Suthrum: So do the patients reach out to you directly or do the GI doctors and primary care providers or anybody else, do they refer members to you? How does the business model work?
Sam Jactel: So for patients directly, it’s a subscription basis, right? Very similar to some of the other health and wellness companies that exist out there. For physicians, it’s a referral pathway. And so what we have built is there is an entire physician ecosystem of tools that we provide to that individual. So if you are the physician recommending Ayble to your patients, I think it’s very important for you to be in the driver’s seat and understand how that data comes back to you. And so we have a dashboard that allows you to monitor and say, okay, Sam’s doing well. And so the next time, right, the next 15 minutes I have with Sam, it’s more impactful, more powerful, and by the way, I’ve driven better outcomes. And we give you all that data. That’s really important and that’s a kind of referral pathway. And then for those enterprise clients, it’s very similar to some of those other groups, right? Per member per month payments or per member per year. And we also are very confident in our data because we published it to drive costs down. We go at risk with some of our fees as well. It’s really important, I think, to align those incentives.
Praveen Suthrum: Are you planning to work with insurance companies? There are some startups that are.
Sam Jactel: So we are part of the UCSF Rosenman Institute ADAPT  program. Recently we’re selected to be a finalist there. That’s a phenomenal ecosystem of insurance groups. I think the groups in that program, I think, manage about 100 million members in the United States. And so we’re working and having conversations with folks like those to be able to provide that is essentially a member benefit to their groups.
Praveen Suthrum: What is the pricing model?
Sam Jactel: The members pay a subscription and yes, yes, exactly. Like, it’s not much more expensive than Netflix, but it’s much more effective. And that’s how we’ve kind of orchestrated that. And then for the enterprise contracts, those are relatively standard enterprise contracts. It’s important to pay for that use. And so it’s those engaged members that we get paid for. And that I think is really important. And there are a couple of contracts that we’re putting together with some others that are like completely value based. We’re sharing on the dollar of savings and on the improvement of outcomes for those individuals.
Praveen Suthrum: So there’s a tendency in the digital health start-up community to apply AI and machine learning on everything. And one of the questions that I have, and I’d like to push back here a little bit, is that really necessary? Because what is the AI going to do? And is it not just a simple algorithm that you need versus a predictive mechanism? Because I think having been a patient, it’s probably more to do with not doing the wrong things versus doing certain specific things, maybe a combination of both. But as I understand IBS, IBD, it’s an act of removal and knowing the triggers and managing what those triggers are. And once it is set, it is set because I’m sure you’re not changing the recommendations or what you do too much after a point of time. Why is AI or machine learning required for something like this? What’s your response or reflection on this whole variability aspect?
Sam Jactel:  Look, I love that question because I think those terms are thrown around a lot and they’re either ill-defined or they’re used, but with no real purpose. And so I’m going to answer this question in two ways. One is I want to illustrate what it looks like to do this on your own, and I hope in illustrating that you’ll understand where these kinds of data models are really important, particularly around the diet piece. I think the other piece to this is our broader ambitions and what we’re trying to do with our company in defining a new gold standard of care on an Iterative basis.
So let me illustrate what it looks like first on the diet side, right? So let’s say a FODMAP pamphlet that gets given to a patient. The onus is then on that individual, you shouldn’t eat FODMAP for the rest of your life.  Right? It’s highly restrictive and that brings on additional problems and certainly very hard to adhere to. And there are some good encyclopaedia type resources to figure out what’s low or high or medium FODMAP, whatever that is. And the interesting thing is that there also is no real consensus about is it FODMAP? Is it nice guidelines? Is it other? The Mediterranean diet, the specific carbohydrate diet.
It’s a very kind of diffuse let me use FODMAP as an example. So you go through the process of eating very low FODMAP for quite a long time. And what that requires you to do is eliminate hundreds of foods, staples of your diet for quite some time, six, eight weeks, something like that. And then what you’re supposed to be doing is the reintroduction of that, because not all of those foods are individualized to you to be exacerbating symptoms or causing symptoms. And so you have to go through an iterative process of reintroducing one food every three to five days. And if you’re doing the math in your head, you have 100 foods reintroducing every three to five days, you’re talking about a year and a half of experimentation. And that’s not to say that then you also have to write down how you feel all the time and then connect the dots. And even working with a dietician, it’s incredibly complicated.
And so the machine learning and the AI tools are there to help reduce the cognitive load on that individual, to make it easier to gather that information and to draw conclusions from it. And the most important part of that is then you can use that to inform a better, faster, more effective program for the next patient on the basis of all the aggregated data and the identified data that we’ve gathered for others. And so it’s a positive flywheel that’s important that we’ve kind of innovated here and patented for this group. And so we take what’s, a year and a half long experimentation process, which, by the way, a lot of people start and never finish, and so you never get the outcomes out of it. And we collapse it to 12 to 16 weeks and proven that we’ve been Ayble to generate outcomes, right? So we improve outcomes for 81% of IBS and IBD patients, and for almost 70% of them, by the end of the program, we’ve gotten them to clinical remission as defined by the Symptom Severity Scores, right? The IBS symptom severity scores the CDI, et cetera. That’s really important.
I think the second part of my answer is that what we’re trying to do here is not just take the standard of care that exists in the clinic. We’ve talked about how it’s not effective, it doesn’t drive optimal outcomes for everybody. And so what we’re trying to do here is, on the basis of this incredible data ecosystem that we’ve developed, and we use that as a positive flywheel to continuously iterate that gold standard of care, right? It’s not just about making care virtual, but not changing outcomes. It’s about using the digital tools to make the outcomes better and more equitable and easier to access for everybody. I think that’s really exciting. And so that’s why it’s kind of like a very core problem that we solve with the ML and AI stuff, right? Same problem also with mental health that we’re working on. But the other piece is just what is our bigger ambition? You cannot get to precision health unless you gather that data, and that data cannot be interpreted unless you use tools like ML and AI. And so that’s kind of how we’re thinking about it. And of course, we may be incorrect, and the value of those models is that we can continue to get better and better over time. And that’s just we have to be humble in the way that we approach it. But that’s the vision.
Praveen Suthrum: One more question on the company and competition and all that. I would argue that there are other companies also in the wellness space that are taking similar approaches for digestive diseases. And there’s one at least that’s been through the FDA gate, taking a digital therapeutics approach. So does the world need yet another digestive disease digital GI company? Or this is the sign of the times. And I’m asking again, with all respect to the clinical side and the patient side of the story, I’m just asking a business question here.
Sam Jactel: It’s a really important question, and I’ll give you a like, but not the answer you want and then the answer that you want afterwards. I think the reality is a gigantic market and the needs are not solved yet. And so we need as many people in the space trying different things as possible to be able to change the lives of patients like myself. And the diabetes market is a good example of this, right? There are half as many diabetes patients in the US. As there are GI patients. And there are hundreds of diabetes companies doing really interesting work, approaching it from different angles, and they’re all finding a good niche in the market and generating solid returns for investors and having sustainable business models. And I think we’re going to see that in GI. It’s a huge market. I think the other piece of this is just how you present yourself to the business ecosystem and what your go to market is. And I think the prescription digital therapeutics route is really exciting, right. And they’re doing a couple of other things, I think insomnia as well, and some other folks like Mahana Therapeutics, metaMe with the Regulora, they’re going through that model. It’s a different approach to the market where certainly there’s a value creation and value capture piece to this, right? They create a lot of value. They capture almost all the value that they generate because of the ecosystem that’s built, right. It’s just like a drug. But I don’t think that you’re going to be able to get the volume right. And I think the reality is that there are tons of people, right? If 25% of a commercially insured population has a GI diagnosis, and then another, let’s say 10 to15% have undiagnosed or under diagnosed conditions. You’re never going to be able to meet the demand with that model exclusively. And so that’s really important for us is like, we want to make this amazing new science and the innovations that we’ve developed accessible for as many people. And the reality is also that the conditions that we are trying to address are really hard to manage with one tool alone. And so I think there’s actually much more collaboration that can be in the system than we maybe expect, right? Because in my view, these are and conditions rather than or conditions. And by that I mean you should do your diet and you should do your psychology and you should do your drugs and you should do your physical.
There’s a lot, but it needs to be tailored to you as an individual, and someone needs to quarterback that. And in lieu of an ecosystem that makes that possible, we think the patient does it right, and we empower the physician to help extend that care as well. So that’s kind of the way that we’re thinking about it.
Praveen Suthrum: Very well answered. Thank you for sharing that perspective. If there’s a patient out there watching this or listening to this and thinking, hey, I want to be in his shoes, I want to turn CEO too, and take my problem head on, what advice would you have for them?
Sam Jactel: First, I think the most important thing, the reason why we’re called Ayble is that we want patients to feel seen in this world, because a lot of times we aren’t. And I told you about voting with dollars and stuff like that. I think it’s also uncomfortable to talk about. And so we are called Ayble because our goal is to make you be Ayble to go to restaurants without fear, be Ayble to travel, be Ayble to be defined by something other than your condition. And so to those patients that are looking at it, we see you, we’ve been in your shoes, and it’s a tough place to be, but we’re trying to solve for what you are living with all the time. And to those that are taking that next step of being not just a CEO of their own condition, but trying to be the CEO of their own company, let’s say, a gift and a curse. I think the gift is that you have a unique understanding of the problem that you’re solving for your ultimate users. And I think that’s really, really exciting because you know what to build, you know what not to build.
I think the curse is me search rather than research. And by that I mean, like, I am an end of one. And we need to be very humble in our understanding that my experience as a white male, privileged, educated individual is not the case for everybody else. And if you make the false assumption that you are your only customer or that all your customers look and talk and feel and live like you, you’re going to have a bad time.  Right. It’s not going to be appropriate. And so the thing that is really exciting about that opportunity is also its potential downfall. And so for those individuals that are looking to go into this space and take advantage of their however many years of research by being that patient, I think it’s also important to hear others and to include others as part of that. And we’ve talked to thousands and thousands of patients, and we use that to inform our decisions. It’s not just me.  Right. And that’s really important, I think we don’t talk a lot about, but yeah, I think that’s a key insight that I learned.
Praveen Suthrum: Final two questions. What’s the future of GI and health care? From the lens that you’re seeing right now?
Sam Jactel: I won’t beat a dead horse. I think the future of healthcare is patient driven. Not just we talk in, like, loose terms about, oh, we are patient centric.  Right. It needs to be at the core of what the actual problem we’re solving, because we can’t get the outcomes unless the person at the end of the day who is sick gets better. And so I think that’s, like, really important.  Right. So the patient driven things, I think, will end up, whoever solves my needs as a patient, better, I think, will ultimately win in the market for a variety of reasons.  Right. Not just for outcomes, but also for contraction. I think the other piece to it is that we are very excited about this. You know, we’re running randomized controlled trials. We did three years of clinical research before we took a dollar from anyone. The bar for clinical evidence needs to keep going up, and it cannot be a non-inferiority thing. We need to keep pushing that up.  Right. That standard of care needs to continue to evolve. And we’re excited to be part of that new trend of first, we should be publishing more of our research, right. In clinical journals. We should be showing how we do that to people, and we should be empowering others to keep evolving. I welcome all the folks in the space to keep building that out and publishing that research. But I think that there’s too big of a gap currently between the claims that companies make in digital health, not just GI, but generally right. And the evidence that supports it. And I also don’t think that it’s good enough to refer to other research. I think the onus needs to be on digital health companies to run their own research of their own brand of doing that care and their innovations. I think it’s important to validate their novel innovations and what they’re contributing to the space. That’s a challenge, for sure.  It’s expensive. It’s hard to do well. But science is so important in this space, and I think we need to lead with evidence because that drives trust and it also drives outcomes and it drives sustainability from a business standpoint for everybody. So that’s, I think, my challenge to the space, it’s a challenge that we’ve issued ourselves. We’re not perfect at it, but it’s something that we’re really excited about.
Praveen Suthrum: So, Sam, in closing, I want you to reiterate that philosophical analogy that you shared with me before we started recording about being the bat versus knowing the bat. So I’ll let you share it, and then we’ll close.
Sam Jactel: I’m glad you can nerd out about this, but yes, I’ve been a big philosophy guy for a while, and there’s a phenomenal philosopher. His name is Thomas Nagel. And Thomas Nagel has an amazing article that I’m happy to share with this community as well, where he makes this proposition where he says, imagine you are the foremost scientist in the bat field, right? You know everything about the physiology of the bat. You know all the neurons, how they’re connected, the chemical signaling. You know how the whole system of the bat works. You know how the echolocation works. You know the difference between the signals and how they find their way through their environment while being functionally blind. You can know everything about the bat. But his proposition is that even though you know everything there is to know about a bat, you will never know what it’s like to be a bat and what it’s like to being this, I think, super important in this space. And the analogy is, I think, very connected to what it’s like to be a patient.  Right? And if we can think more like that, I think we’re really going to change the world.
Praveen Suthrum:  On that note, Sam Jactel. I’m so glad that you came on The Scope Forward Show. Wish you and your team all the best, and I really wish for more patients like you to step up, take action, and start companies in the GI space because there is a lot of need. Thank you once again.
Sam Jactel: Yeah, thank you so much for the opportunity. And I welcome the discussion with the rest of the GI community. Would love to chat with GIS, with other folks, kind of innovating in the space. And it’s a really exciting time. This is the right time and the right place to be building for people in this ecosystem. So go forth and prosper. I appreciate the opportunity. Thank you.


COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
09 Jan 2023

Curated GI articles January 7th, 2023: One GI, Gastro Health expand | FDA nod for OverC multi-cancer blood test | Amazon to buy practices?

Curated GI articles January 7th, 2023:
One GI, Gastro Health expand | FDA nod for OverC multi-cancer blood test | Amazon to buy practices?
One GI® Continues Tennessee Expansion (PR Newswire)
One GI, the home for independent gastroenterology, continues its Tennessee market expansion with Skyline Gastroenterology and Skyline Endoscopy partnerships.
Gastro Health Finalizes Partnership with Gastroenterology Associates in Olympia (Gastro Health)
Gastro Health, a national leading medical group specializing in digestive and liver health, has finalized a partnership with Gastroenterology Associates in Olympia, Washington.
GI physician shortage ‘a significant concern’ affecting both providers, patients (Healio)
The U.S. Department of Health and Human Services has predicted that there will be a shortage of gastroenterologists in the near future due to increasing demand for healthcare providers.
AI Revolution in Gastroenterology Is Closer Than We Think (Medscape)
The once-futuristic technology is producing tangible results in the here and now, says Dr. Ben Levy.
FDA Grants Breakthrough Device Designation to A Multi-Cancer Detecting Blood Test (Cancer Network)
The blood test is intended for use in detecting a range of cancers—including liver and lung cancer—among adults ages 50 to 75 years.
Private equity insights from 2022 (Healio)
Healio’s Inside Private Equity blog series features legal insights on physician practice consolidation from Allison W. Shuren, JD, MSN, and J. Matthew Owens.
New York gastroenterologist to pay $1.4M for Medicare billing fraud (Becker’s GI & Endoscopy)
From October 2015 through February 2020, the defendant submitted over $3 million in billings to Medicare for gastroenterological procedures that were not performed.
AGA Guidelines Update for IBS Accent Need for Personalized Medicine (GI & Endoscopy News)
Since the AGA’s first IBS technical review in 2014, new treatments have become available and evidence for some of the existing treatments has grown.
How Mayo Clinic will accelerate Endiatx’s PillBot development (Medical Design & Outsourcing)
The latest version of Endiatx’s PillBot is shorter than any pillcam on the market and has a diameter equal to or lesser than any other pillcam.
The 6 challenges facing health care in 2023—and how to handle them (Advisory Board)
With input from stakeholders across the industry, Modern Healthcare outlines six challenges health care is likely to face in 2023—and what leaders can do about them.
Weight loss management … a new frontier? (MDedge)
Experts discuss the advantages of medicine, lifestyle management and endoscopic therapies for obesity treatment.
Physician group practices struggle with bundled payments: study (Fierce Healthcare)
When compared to hospitals, physician-group practices don’t fare quite as well in bundled payment arrangements, according to a new study.
Why I decided to get an MBA after becoming a private practice gastroenterologist (MDedge)
Dr. Vasu Appalaneni (Practicing gastroenterologist at Dayton Gastroenterology & Executive VP of Clinical Innovation at One GI) shares her experience.
The Future of Polyp Detection with Dr. Shrujal Baxi Iterative Health (Empowered Patient Radio)
Dr. Shrujal Baxi (Medical oncologist and CMO at Iterative Health) discusses the developments in colonoscopy and endoscopy technology she is most excited about.
Study reveals common, serious gut disorder is often misdiagnosed (The Print)
The research found that many individuals have similar symptoms to other gut- and brain related-disorders, such as functional dyspepsia and gastroparesis, leading to misdiagnosis.
metaMe Health Gains Worldwide Licensing Rights to Gut-Directed Hypnotherapy Protocol for Functional Dyspepsia (HCP Live)
Agreement with Dr. Sarah Kinsinger and Dr. Olafur Palsson gives metaMe Health global rights to develop and market the digital therapeutic.
Amazon Could Fuel Doctor Buyouts In 2023 If One Medical Deal Goes Through (Forbes)
The already hot market of buying physician practices is about to get even hotter should Amazon’s proposed acquisition of One Medical win regulatory approval.
Podcast: John Carethers (part 1): Deep dive with the AGA president (AGA)
Hosts Drs. Matthew Whitson, Nina Nandy, and CS Tse sit down with AGA President Dr. John Carethers in this two-part special to chat about his career and how his involvement with AGA has impacted him.

More Hot headlines in GI

Register: 2023 AGA Tech Summit (AGA)

GI Alliance Announces Appointment of Two Industry Leaders to the Board of Managers (PR Newswire)

Silicon Valley is coming for your gut biome (CNBC)

Roivant touts Phase II win for Pfizer-partnered ulcerative colitis drug (FirstWord Pharma)

Promising Role of ctDNA Is Explored in GI Malignancies (Targeted Oncology)

Saint Joseph Hospital Using New Technology for Colorectal Cancer Screenings (Saint Joseph Hospital)

Magic Leap 2 Is The First AR Device to Receive 60601 Certification For Use In The Operating Room (Magic Leap)

Are single-use scopes the way of the future? (ASGE)

Videos: Interviews with GI Leaders  (Scope Forward Show/NextServices)

COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
24 Dec 2022

Curated GI articles December 23rd, 2022: Olympus to takeover AI in GI startup for $80M | Freenome joins CRC liquid biopsy competitors

Curated GI articles December 23rd, 2022:
Olympus to takeover AI in GI startup for $80M | Freenome joins CRC liquid biopsy competitors
What the omnibus bill means for GI (AGA)
The $1.7 trillion omnibus appropriations bill that Congress recently released contains positive news for GI.
SF Interview: “Physicians Are At The Epicenter Of Changing The Way We Live Our Lives” (NextServices)
Learn why (and how) AGA chose to go down the route of venture investing, why the market opportunity for GI is enormous, how to invest and participate in the GI Opportunity fund, and more in this exclusive Scope Forward interview.
Medicare and Insurance Policy Updates in 2023 Will Improve Cancer Screening Access by Removing Patient Colonoscopy Cost Following a Positive Cologuard Test (PR Newswire)
The policy changes require Medicare and most commercial insurers to pay for colonoscopy after a positive Cologuard® test without cost to the patient.
The biggest obstacles the gastroenterology industry faces (Becker’s GI & Endoscopy)
Shrujal Baxi, MD, chief medical officer at Iterative Health, discusses the biggest obstacles the gastroenterology industry faces today on a patient, provider and pharmaceutical level.
Olympus agrees to $80M takeover of artificial intelligence endoscopy startup Odin Vision (Medtech Dive)
Odin is a London-based developer of Caddie and Cadu, cloud-based AI systems that are designed to help detect and characterize cancerous and precancerous tissues during colonoscopies and gastroscopies.
Private Equity & Healthcare: Antitrust Enforcement In 2023–PE Roll-Ups In The Cross Hairs (Mondaq)
As we move into the new year, private equity firms engaging in healthcare transactions should take into account recent enforcement actions and guidance from the agencies.
Investing in the Future of Chronic Care Management in Gastroenterology (Becker’s GI & Endoscopy)
Allied Digestive Health’s Chief Medical Officer, Nadeem Baig, MD shares his insight on the benefits and future of chronic care management.
Freenome CEO Mike Nolan talks colorectal cancer test, clinical trials (Medtech Dive)
The San Francisco-based company recently enrolled in a clinical trial for its blood-based cancer test but faces competition in the market for minimally invasive cancer tests.
I asked a bunch of health-tech experts for their not boring ’23 predictions (Second Opinion)
A group of experts from different areas of the healthcare sector makes predictions about a specific aspect of their field including biosecurity, mission-critical tools, rising medical costs, and more.
Patients With Gastrointestinal Conditions Consider Telehealth Equivalent to In-Person Care (Gastro Journal)
The aim of this analysis was to compare patient experience with telehealth with in-person office visits across multiple community-based private gastroenterology practices.
AI versus other interventions for colonoscopy: How do they compare? (MDedge)
Colonoscopies with artificial intelligence demonstrate significantly better adenoma detection rates (ADRs) than most other endoscopic interventions, according to a new report.
Should You Quit Employment to Open a Practice? These Docs Share How They Did It (Medscape)
Last year, the American Medical Association found that, for the first time, less than half of all physicians work in private practice. But does employment mean happiness?
Cleveland Clinic gastroenterologist charged with assaulting patients (Becker’s GI & Endoscopy)
A Cleveland Clinic gastroenterologist accused of assaulting three patients during exams has been fired, a hospital spokesperson confirmed.
Virtual nurses, bots, AI: Digital health predictions for ’23 (Becker’s Healthcare)
A “headline-grabbing” health system/digital health company merger? Less digital health investment from hospitals? These are some of the digital health forecasts made by health system chief digital officers for 2023.
2022’s Top 10 Gastroenterology Publications (Medscape)
A list of 10 articles compiled by Medscape offers the greatest practice-changing implications, now and in the years to come.
US Digestive Health Announces Eight New Physician Hires (Benzinga)
The rapidly expanding practice has increased hiring in 2022-23 as patient demand for accessible, high-quality GI care continues to increase.
Gastro Health in 2022: 10 moves (Becker’s GI & Endoscopy)
Miami-based Gastro Health continued to expand in 2022, with 10 major industry moves and partnerships.
Airtel, Apollo, AWS carry out India’s first 5G-driven, AI-guided colonoscopy (Economic Times)
The AI-guided colonoscopy procedure helped in image processing in real-time, and will enable an “extra pair of eyes” for physicians and improves the detection rate of polyps.

More Hot headlines in GI

Top 100 Digital Health Companies In 2022 (The Medical Futurist)

Endoscopic Tattooing: When and How to Do It (GI & Endoscopy News)

Commonly used food dye may trigger Crohn’s, IBDs and Ulcerative Colitis (Medical Dialogues)

2023 forecast: Providers embrace start of new requirements on health equity (Fierce Healthcare)

VIDEO: Physicians should rely on clinical expertise as foundation for social media presence (Healio)

Register: 2023 AGA Tech Summit (AGA)

Expert Perspectives on Guideline Updates for NASH (ReachMD)

Genetic Counseling, Testing Is Suboptimal In Young-Onset CRC (GI & Endoscopy News)

Gut-Brain Axis: The Connection Between Illnesses of the Digestive and Nervous Systems (Neuroscience News)

Potential Therapy for an Aggressive Type of Colon Cancer Identified in Preclinical Studies (Weil Cornell Medicine)

Videos: Interviews with GI Leaders  (Scope Forward Show/NextServices)

COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
22 Dec 2022

“Physicians are at the epicenter of changing the way we live our lives” – AGA launches GI Opportunity Fund

“Physicians are at the epicenter of changing the way we live our lives”
AGA launches GI Opportunity Fund
Scope Forward has always been about finding the way forward for gastroenterology. Naturally I was excited that a leading GI society such as the American Gastroenterological Association (AGA) was scoping forward  by launching a venture capital fund called the GI Opportunity Fund (in partnership with Varia Ventures).
What was even more exciting is that AGA chose to invest in Virgo to launch the fund. I interviewed Virgo’s cofounder Matt Schwartz earlier this year – we talked about the value of data in GI.
In this interview, you’ll learn from Tom Serena (CEO of AGA) on why (and  how) AGA chose to go down the route of venture investing. How the market opportunity for GI is enormous. How to invest and participate in this fund? If you are an entrepreneur, how to land an investment.
More importantly, you’ll understand the central premise of this interview. As Andrea Vossler, Cofounder and Managing Director of Varia Ventures said, physicians are the epicenter of medical care. You are the ones who are innovating. It’s time to step forward and make your ideas into a reality. If you listen closely, Matt has this one piece of advice for GI entrepreneurs.
◘  Why is AGA getting into venture investing
◘  “We have been staying sharply focused on GI”
◘  “The market opportunity for GI is enormous”
◘  What kind of GI or health tech companies will Varia invest in?
◘  How will the GI Opportunity Fund help Virgo?
◘  What benefits does Virgo offer to the GI community?
◘  What kind of exit horizon do these investments have?
◘  “Our goal is to get Virgo integrated into as many health systems around the globe as quickly as possible”
◘  “Pivoting,” within a large organization such as the AGA
◘  How will the GI Opportunity Fund evolve in the coming years?
◘  “We’re all looking at private equity and how that’s going to affect not just GI but us”
◘  “Physicians are right in the epicenter of changing the way that we live our lives” 
◘  What is the process of becoming an investor in the fund?
◘  What is the typical size of the investments that the fund makes?
◘  The number one piece of advice to entrepreneurs in the GI space
◘  What is the future of GI? 

The Transcribed Interview:
Praveen Suthrum: Hi everyone. Welcome to The Scope Forward Show. I’ve been really looking forward to doing this interview for a while now, so it’s exciting. You have some great news, Tom, so congratulations to AGA and the whole team. I first want you to make the announcement that you have that will help us get started. Then I want to introduce everyone.
Tom Serena: I am Tom Serena, the CEO of the American Gastroenterological Association, and we have recently, in partnership with Varia Ventures, launched a venture capital fund called the GI Opportunity Fund.
Praveen Suthrum: Excellent. So, Tom Serena, you’re the CEO of the American Gastroenterological Association. Matt Schwartz is co-founder and CEO of Virgo. And Andrea Vossler is co founder and managing director of Varia Ventures.
So all of you have come together to make an investment in Matt’s company, Virgo. And it’s great. You’ve created this investment fund and you’ve made your first investment. So it’s exciting and congratulations to all of you.
I want to start first by asking you, Tom, what is the back story here? How did you go about it? How did AGA as a GI Society decide to go down the route of venture investment, which is something new I would think for medical specialty society.
Tom Serena: I would say it’s pretty unique. But we did learn something from our GI Society—SAGES: The Society of American Gastrointestinal endoscopic Surgeons. AGA, we referred to as the centre for Innovation and Technology a dozen years ago. It’s basically a group of experts who can give guidance to start-ups founders and a physician entrepreneurs. And we did that for a number of years.
We have an annual tech summit with a shark tank event embedded in that. And as I said, it went on for a little over a decade. But the problem that we saw was we didn’t cover the last mile where companies want funding. And the opportunity came to us because one of our board members, Mike Coachman, was connected to SAGES, who had already been working with various so this was kind of serendipitous, but it really worked well because we found the last mile because now we can help companies get funded as well.
Just as part of the back story, we’ve been trying to do something for a decade, but associations move slowly and they’re pretty conservative. So we had some fits and starts and it took a while to get comfortable with this. We made our first actual direct investment in a start up, RX Health, in 2018. So it sort of got everybody used to, okay, this is a new era and a new frontier. And now the board is really excited. They see the synergy of having the ability to do this funding.
The key to getting everybody comfortable, I will say, is how comfortable we are working with Varia ventures because having a partner who knows what they’re doing is really what we need if we can do the clinical side. But we really didn’t have any experience in venture capital, so that shows how we got here.
Praveen Suthrum: Andrea, your fund or firm, you help entities like AGA invest or do you also invest? What is the nature of your business?
Andrea Vossler: Yeah, so Varia Ventures is a venture capital firm started by my partner and I. We partner with medical societies and other professional organizations to help them launch and manage their venture programs.

As Tom mentioned, we have been staying sharply focused on GI. Our initial partnership was with SAGES, which is how we got connected to the AGA. And what’s great about that is there’s opportunities for synergies, obviously, across both organizations that are focused on GI, including beyond resources and key opinion leader support, the ability to co-invest from time to time in interesting opportunities.

Praveen Suthrum: What kind of investments have you already made in GI?
Andrea Vossler: I’m glad we’re having this conversation. Virgo is our first investment through the fund. We are actively fundraising through both funds, although we have held an initial close at the AGA fund and we’ll have another close before year end.
I know Praveen, one of your questions a bit later on is how can people participate, which I’ll cover then, but we are generally looking I will say our investment thesis is to invest in early stage high growth opportunities. We’re primarily looking for companies that originate through the AGA or are in the GI space. Our interest, I would say, is from a market opportunity standpoint.
The market opportunity for GI is enormous, I think digestive health issues and the impact of nutrition on health such as everyone. So we’re really excited about it from an investment standpoint. So in addition to investing in GI and investing in early stage companies, we’re looking at interesting opportunities where there might be limited competition, there’s a significant market opportunity. There are other smart investors around the table who invest in this particular industry. We look for a great team like Matt’s in place, who are disciplined and dedicated. We often look for positive indices of traction. It can be trials, it can be initial partnerships, it can even be revenue, although that does have to be later stage. So those are all the sort of things that we look for when we’re thinking about making an investment through the AGA fund. And our hope is that we will have, at least in this initial fund as we get going because it’s a new initiative for the organization that will have a nice portfolio of somewhere between five to eight, maybe even ten investments, depending on how much capital we close on in this initial fund.
Praveen Suthrum: Excellent. And coming to GI itself and this portfolio that you’re considering building, does it have to be digital GI companies or it doesn’t matter what kind of start up companies?
Andrea Vossler: No, that’s a great question. They don’t have to be digital GI companies. We primarily look for either medical device or health tech companies. We tend to stay away from pharma, mostly because the pathway to exit is very, very long. It can be ten to 15 years and it’s often too long to provide a return to our investors. However, that being said, if there were really compelling opportunity and it was closer to market, we might consider it.
But generally speaking, we do focus on medical device and healthtech you don’t need to be in Healthnet, you could be a medical device. And about 20% of the portfolio will be allocated to making investments outside of GI. So that could be in other healthcare companies and it could even potentially be outside of healthcare. But because this is partnership with the AGA and we sort of the missing piece, I would say, as Tom mentioned, with the work that they’ve done over many, many decades, we are staying pretty sharply focused on GI. But if you are in health care and you have a compelling opportunity, we will consider a company here and there to ensure that our portfolio is diversified for our investor base.
Praveen Suthrum: And does it have to be US based or is this global?
Andrea Vossler: We do look at foreign companies. We have foreign companies apply, we will consider them. There is some complexity with investing outside of the US. So I would say if you’re interested, please apply. And if it’s not the right fit from a structural mechanic standpoint, we’ll let you know upfront so that we don’t spend a lot of time looking at your company and are doing diligence if it’s not going to be workable for us from an investment standpoint.
Praveen Suthrum: The reason I asked that question is because I see a lot of innovation in GI happening outside of the US. And they’re selling in the US, all of them, but the innovation seems to originate in different parts of the world. It’s quite an interesting thing that I’ve been noticing, but sure, thanks for answering that.
So Matt, it’s a full circle for you. Just a few minutes ago. I was asking Tom, didn’t Matt pitch at the AGA Tech summit? And he said you did. And I asked, did you win? So he said, no, he did not win. So it really doesn’t matter whether you win or not, you can get the investment. That’s a good one. So congratulations to you and your team. Since the last time that we did this interview on The Scope Forward Show till now. You made the Olympus investment announcement and now the AGA. So it’s incredible. So it’s a full circle for you. I love to get your reflections. How do you feel having arrived at this point?
Matt Schwartz: Yeah, thanks for being it’s incredibly rewarding for us to now officially have the AGA as a partner in our company. Looking back over the years, not only did we pitch in the shark tank back in 2018 and as you said, we didn’t win, but it was a great experience. We actually really started the company the year before after attending the AGA Tech Summit, me and my co founder Ian, we went to the Tech Summit on the recommendation of Dr. Dravid Cave. Thought it’d be a great place for us to go and explore the concepts we were kicking around for Virgo. And we received such positive feedback from the attendees at the Tech Summit who were incredibly encouraging and supportive of what we were doing.
And it really gave us the confidence and understanding that we needed to go out and start the company with a focus on the GI space. So it’s just so rewarding to now be able to have the AGA as an official partner in what we do. And it’s hard to believe that was almost six years ago now. But the company has come a tremendously long way since then.
Praveen Suthrum: So it offers tremendous credibility to have a partner like AGA. And I’m sure this is not about the money, it’s beyond that. Can you talk a little bit about that? How does this investment help you? I’m sure you could have taken this money from anyone else who have in the pipeline.
Matt Schwartz: First of all, we really trust the AGA and its membership in their thought expertise. And beyond just the credibility and the money, that’s what’s most important to us is that the AGA has a broad and diverse membership that can give us really valuable feedback. And ever since the beginning of our company, we’ve valued physician input in helping to guide our product development and focus on the things that are going to be most important and impactful for them. I think having that exposure to the AGA’s membership just helps to accelerate the amount of feedback that we can receive in and think gaining more exposure to the AGA’s membership so they understand what it is that we’re building toward can be incredibly impactful. So I think that’s probably the number one thing we look for.
Number two is as we grow as a company, I think historically we have not really played in spaces that are directly reimbursable, but I think that could become more of a longer term strategy. And knowing that the AGA and its membership plays such a significant role in helping guide policy in the GI space, I think that’s going to become a strategic advantage for us just to understand where the winds are headed when it comes to reimbursement and policy long term by having a more direct relationship with the AGA.
Praveen Suthrum: That’s a very interesting point. Just for context, Matt, can you please recap what Virgo does as a company and what kind of benefits do you offer through your solutions to the GI community?
Matt Schwartz: So at Virgo, we provide the leading cloud video capture management and AI analysis platform for endoscopy. Since launching in 2018, we’ve helped physicians around the country and now starting to be around the globe, capture over half a million endoscopic procedure videos.
And then starting in 2021, we launched a new suite of tools called Virgo Trials that’s designed to help biopharma companies accelerate clinical trials in IBD and other diseases that involve endoscopy. So our core platform, we’ve got a small device that helps doctors automatically record their Endoscopy videos. We help doctors use those videos just in standard of care treatment. We also enable doctors to use their own video data for research programs, training programs, quality improvement initiatives, and then the clinical trial benefits are pretty clear. We can help doctors get more of their patients enrolled into clinical trial opportunities.
So there’s a number of different value propositions, kind of depending on who the target audience is, whether it’s academic medicine, private practices, biopharma companies. There’s something in the Virgo platform for everyone. And we’re really committed to building innovative tools for whoever the audience is. It’s not just one thing for one group. We want to make sure it’s really targeted platform for all audiences.
Praveen Suthrum: I’d like to know what kind of an exit horizon do these investments have? Are we talking five, seven years or shorter? What is typical here?
Andrea Vossler: I can answer that, Matt, and then maybe you can speak more specifically to Virgo. Generally speaking, we see these investments exit and I would see a three to seven year time frame investments where we invest and they’re a bit farther along.
We’re investing in sort of a seed to Series A. And what that means is seed, there’s some positive indices of traction. A, you’re getting into an inflection point where they’re really focused on growth. And so just by operation of vesting at one of those stages and the check size that one might be investing in, that sort of dictates the length of time that may elapse until there’s an exit.
Now, that being said, we do look in terms of what we invest in from an investment criteria standpoint, we do look for companies that are going to exit quickly. But as Matt mentioned, he’s been in business for, I think Matt, you said six or eight years. It takes time for these companies to mature. Our past investment experience, we see these companies exiting in three to seven years. You may occasionally have a company that exits quicker than that, and you always have stragglers that exit beyond the seven year. It’s one of the reasons that a standard fund terms ten years and I’ll let Matt speak more specifically to Virgo and what they’re anticipating in the future.
Matt Schwartz: We started the company back in 2017 and I think one of the things that is unique to healthcare and start-ups is that healthcare is a complex industry, very complex incentive structures, and it can be time consuming and challenging to find the right business model that really cracks that code and works for everyone in your ecosystem. And so we spent the first couple of years with Virgo focused primarily on building product and understanding the market and trying to build a foothold with leading academic medical centres in the country to buildout the base of our business.
And then from that we always knew we would overtime, uncover the right venture scale type of business model. And we think we really struck on that with the launch of our Virgo Trials product and being able to work so closely with leading pharmaceutical companies. And we’re seeing tremendous results there. But now with this investment, this was part of our Series A raise. You mentioned Olympus also participated in the Series and our focus now is on growth. Our goal is to get Virgo integrated into as many health systems around the globe as quickly as possible. That’s what our primary focus is on at the moment.
I think there’s a ton of runway for us in company building just directly. We’re not so concentrated on exit strategy at the moment, though I do think there will be an attractive exit opportunity sometime in the next call. It three to five years. But at the moment we are really just laser focused on building up the company and spreading Virgo across the globe as quickly as we can.
Praveen Suthrum: Tom, I want to get back to you on the whole decision making process, or the Pivoting process if you will. For a large organization such as the AGA, I’m sure you must have faced resistance with your board with your own staff and so on. And the reason I want to bring up this topic is because there could be other large entities, other large organizations out there that must be reflecting on similar questions, ideas and so on. They must be thinking, hey, how do I convince my partners, how do I convince the board? How did you navigate all this with the AGA and what kind of resistance did you face, how did you circumvent that?
Tom Serena: So as I said that our partnership with Varia was key. You need to have people that you trust. But I will say the keystone of this is Mike Coachman. It’s a person that the board trusts. Mike was on the board. He’s an advanced endoscopist at Penn. He is well aware of how venture works. He’s worked with many small compensates and they trusted him. So my role is to sort of navigate it through the board, get the approval process done. And honestly, I wish there was a formula, but it’s all about people you trust and especially getting outside the lines of our traditional business lines. Concerns about conflicts and those things had to be overcome.
But eventually I think our board realized it’s sort of the traditional business lines of a society. Education publication induced. They’re static or declining and the competition is unreal, especially when you think about publications and open access issues. So we need to expand our business lines. Sorry if I’m repeating myself, but it is about having somebody who the board trusts sort of bring the idea to fruition.
Praveen Suthrum: Got it. So I want to touch upon that aspect of business lines for a GI society. So it’s not the education and that means through conferences like DDW and through publications and other means of education. But this is completely out there. Right? So this is venture investing and where the risk is high, the chance of failure is high, and so on. So putting all this into context, what do you see as the future of AGA? Where is all this going? If you have to throw a stone and we land five years from now, how do you see all this play out and evolve?
Tom Serena: I see the GI Opportunity Fund as an inflection point. The fact if I have every confidence this is going to go great, it’s important that it’s successful because the board can then take the next risk. The show and I pass around your weekly digest, we’re all trying to figure out what the next thing is. Of course, we’re all looking at private equity and how that’s going to affect not just GI but us. Private equity can provide a lot of resources that we historically have done.
AI from a standpoint of how do we address physician burnout? Because we see volume coming through multiples increasing in GI, because the lowering of the screening age and just the multiple therapeutic. So I really wish I had an answer. I’m kind of exhausted just from getting us to the Opportunity Fund. But we’ll keep looking.
Andrea Vossler: I might just jump in and say tattoo and Mike coachman Alison Kim and others within the AGA have been tremendous partners and they have done tremendous work, I think, to get their internal organization wrapped around this idea. On our end, my partner and I think one of the reasons that we partnered with AGA and the AGA was attracted to us is because one of our missions is to monitor access to venture capital. And my partner and I have a long history of working with physician founders and physician investors.
And the challenges in working in healthcare are significant and they’re getting more challenging as the regulatory regime changes and as there’s increased pressure on many of the physicians in our network. And they’re innovating the next big thing. I mean, they’re right in the epicentre of changing the way that we live our lives and the value of that. It’s been challenging for them to capture because unless you’ve had access to traditional venture capital which typically require checks in the $250,000 million range to participate in the fund we’ve really tried to make the fund accessible to the membership and accessible generally so that the individuals who are innovating are able to participate in the upside of that.
And I will know as well, our economic arrangement with the AGA is to share in successful deal exits. So the focus is to create a sustainable initiative for the AGA, not just because we’d like to set up the next fund, but the next fund after that and after that because we believe it could be a long term, very sustainable and successful model.
Praveen Suthrum:  If there are people out there in the industry, could they become investors in the fund and what does that process look like?
Andrea Vossler: We are working hard to close the fund. By the end of this year we have had an initial closing, we will probably have one more closing and then close out the fund and deploy the capital. So I would encourage anyone who’s interested in investing to reach out. They can reach out to myself, to Tom, or they can go to our website, which, and you can log onto the site register, you can access the fund materials, you can set up a call to speak with myself or my investment partner.
There’s different mechanisms to participate. If you’re interested but you’re uncertain, I would say check out the website and give us a call and we can talk through some of your questions. There’s also a webinar that we hosted about a month ago which includes a general overview of the fund as well as specific questions that investors had that I think a lot of investors had and that’s posted on the portal as well. So that’s easily accessible for anyone who’s interested.
Praveen Suthrum: And does it have to be clinicians only or open to anybody in the GI space?
Andrea Vossler: It’s open to anyone in the GI space with the one caveat that they do need to be an AGA member. But I think you’re not a member. Enrolled as a member is pretty straightforward and I think it’s a very small membership fee.
Praveen Suthrum: So there’d be a lot more people wanting money than putting in money out there. So I want to ask on their behalf, what does that entail? So if there’s an entrepreneur out there and is looking to be in Matt’s shoes, what do they have to do? What does that process look like?
Andrea Vossler: So we connected with Matt because he had contacts within the AGA. So I would say, at least initially, if you have a lead within the AGA or you know someone within the AGA that could make an introduction, we always welcome the soft or the warm introductions because I think that’s helpful. You have someone who can say that they’ve either watched the company or worked with the company. So we’ll take a closer look at it.
But even if you haven’t had any connection to the AGA, that’s not a problem. They go to the website as well. There’s a separate registration form for founders so they can submit their information or submit their interest. We are being a little careful with accepting too many applications right now until we finalize closure of the fund. But as long as you go on and sign up and submit your pitch deck, we’ll be reaching out to you probably after this month, once we complete our final closing.
Praveen Suthrum: And what kind of check sizes do you write or planning to write?
Andrea Vossler: Yeah, so our this initial fund, because it’s our first initiative with the AGA, it is a small fund, so our check sizes are probably going to be, I would say, in the $50,000 to $250,000 range in terms of an initial check size. And if we have additional capital for follow and financings, we’re retaining a little bit of a reserve for that.
And this is what we did with Matt’s company as well. We do have partner funds. So, as Tom mentioned, we’re working with SAGES and setting up a fund that one has a bit of a different focus on SAGES innovations. But to the extent it might be an interest tone of our partner funds, we can co invest together to bring up the size of the check. So in Matt’s company, we wrote a $250,000 check out of the AGA fund, and then one of our partner funds matched that for a $500,000 investment in total.
Praveen Suthrum: Excellent. So, Matt, I want to get back to you, and I’m sure there are a lot of entrepreneurs out there who might be looking up to you right now and wanting to know how can they be in your shoes or how can they take the path that you’ve taken? What advice do you have for them? Again, not just broadly healthcare, but specifically GI. And how is this different from the wider industry, wider sector of healthcare?
Matt Schwartz: Yeah. So the number one piece of advice I give to any entrepreneur I meet in the GI space is that they have to attend the AGA Tech Summit. And I know this probably sounds like just a plug for the AGA, but it really meant a ton to our business. And I’ve worked in a number of different clinical areas within healthcare and have been to all sorts of scientific meetings across different clinical specialties. And I can honestly say what the AGA has cultivated in the Tech Summit is unique across anything I’ve seen in healthcare. The Tech Summit really fosters open communication between physicians, entrepreneurs, larger industry players, and the FDA.
In my experience, it’s a great opportunity. Whether you’re a physician, entrepreneur, someone coming from industry, if you just have an idea and you’re very early stage, the Tech summit is really the place to connect with the right people within the GI community to help grow your concept, whether that means finding medical advisory board members or finding early customers. I think the AGA Tech Summit is the best place to do that.
And I think back to the first Tech Summit we went to in 2017. I think all of our initial customers came out of meetings that we got at the Tech Summit. And when you go to a lot of scientific meetings, it can be difficult to approach physicians that you don’t know. They’re oftentimes there just to present their own research and network with their colleagues and leave. And at the Tech Summit, pretty much everyone that shows up there is looking to learn about something that they’ve never heard of before, which is the perfect environment for an entrepreneur. So I’d say, as Andrea said, it’s always helpful to have a warm lead to someone at the AGA. If you’re an entrepreneur out there right now that doesn’t have one of those warm connections, the best way to build that network is by going to the Tech Summit, which I think is always in April. It used to bounce back and forth between San Francisco and Boston. I think it’s in San Francisco now. You’re going find me there. I’m happy to try to provide more advice and do more networking, but that’s the best advice I can give.
Praveen Suthrum: Excellent. Now I want to close by asking a broader question to the whole group, and all of you can pitch in, which is based on whatever you’re seeing happening in GI right now. And I’m sure you’ve been looking at the space for a while from different lens. I’m interested to know what is the future of GI from the lens that you’re seeing?
Matt Schwartz: I can take it first if you guys want. So I’m a little bit biased here with the nature of our business, but I think data is playing an increasing role in the GI space that goes from everything from AI, which is built on the foundation of having large data sets, to just more precision medicine and predictive analytics. I know there’s a ton of interest in the start up community around using AI to build new treatment protocols. In the biopharma space, there’s a huge undertaking to discover new data based biomarkers, whether that’s genomic biomarkers, microbiome biomarkers, endoscopic biomarkers. And so I think increasingly the GI community is looking for new ways to capture and build robust and well annotated data sets. I think that’s going to have an increasing impact down the road, basically, on all aspects of care, from pharma treatment to endoscopic therapies.
Andrea Vossler: I might just add, and Tom has a bit more insight into this, but the AGA has a number of research centres at the AGA, including, I think, a new one just spun up around AI to your point. I don’t know, Tom, if you want to maybe give a little background on some of the research centres and that is where some of the deal flow coming from.
Tom Serena: Matt. That was great insight. We had a consensus conference around AI we just didn’t want to repeat. I mean, there are organizations focused on this. We’re not going to be at the bleeding edge, but we’re trying to figure out what AGA’s niche is with regard to AI.
I would also say one of the things we’re heavily investing in from a time standpoint, or clinical trials and Matt, this ties to Virgo as well, because just diversity of trials and just helping to capitalize enrolment just to be more creative and figuring out the keys to recruiting patients, frankly, that’s kind of boots on the ground. It’s not as sexy as tech, but it’s so important.
Praveen Suthrum: Anything else that all of you wanted to talk about or share before we wrap up today.
Tom Serena: The one thing I was really surprised at when we started fundraising for the fund, I kind of had in mind your typical investor. But I probably personally know only about 20% of the investors that the people that were interested in this fund and are earlier in their career than I thought they would have been and incredibly enthusiastic. And I found these, like, gold veins of investment clubs. They’re already working together to make other investments. So I just sort of discovered a whole new world. And it’s really gratifying because I think VC is probably complicated if you haven’t been or maybe intimidating if you haven’t been involved in it. Like, it’s high risk where I think these early on investors understand how it contributes to a diversified portfolio. So something I’ve learned.
Praveen Suthrum: Thank you for sharing that.
Matt Schwartz: That’s a great point. Just a second. That I think it’s only been, what, maybe a week, week and a half since we announced this investment with the AGA. And it’s been fun. I’ve been on the road the past couple of weeks and have run into physicians now who told me that they’re participants in the AGA’s GI Opportunity Fund, which is amazing to hear.
Historically, we would oftentimes run into physicians who were curious about investing in Virgo, didn’t exactly know how to do it or what the right pathway was, and we didn’t always have a good vehicle for them to make smaller investments. And so I’m grateful that the AGA has given the physician community that sort of an opportunity to be participants in helping shape new innovation in the field. It’s great.
Praveen Suthrum: So congratulations once again to all of you and to your teams. This is amazing. And this is exactly the kind of things that I look for through the Scope Forward lens. I want to see what’s new and who is innovating in what way. So this is an amazing announcement. So I wish you all the best and thanks so much for coming on the platform and making this announcement.
Tom Serena: Thanks for the opportunity. I really enjoyed it.
Matt Schwartz: Yeah, thanks. Praveen, as always.


COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
17 Dec 2022

Curated GI articles December 16th, 2022: FDA-approved, Medicare-paid blood test for CRC | Microbiome kits are the Wild West of Gut Health

Curated GI articles December 16th, 2022:
FDA-approved, Medicare-paid blood test for CRC | Microbiome kits are the Wild West of Gut Health
Good news, bad news for GI in 2023 CMS physician fee schedule (MDedge)
CMS uses its annual updates of the Physician Fee Schedule to make myriad policy decisions, with the 2023 version of the rule running close to 3,000 pages.
Healthcare dealmaking will heat up in 2023 with plenty of corporate cash, PE ‘dry powder’ (Fierce Healthcare)
Increasing transaction volumes and players embracing value-based care—coupled with large levels of corporate cash and private equity “dry powder”—are leading to continued expansion for deal volumes.
A frozen capital market and an insurance premium shock: 10 health care predictions for 2023 from top investors (Fortune)
A list of annual healthcare predictions for 2023 published by Fortune, covering a range of topics such as the potential consequences of new weight loss drugs, a record number of health tech M&A, and the expected uptake of ICHRAs and more.
Guardant Health announces positive results from pivotal ECLIPSE study evaluating a blood test for the detection of colorectal cancer (Business Wire)
The results will pave the way for first potential FDA-approved and Medicare-reimbursed blood test for colorectal cancer screening.
Performance and comparison of artificial intelligence and human experts in the detection and classification of colonic polyps (BMC Gastroenterology)
The study aims was to analyze the performance of different AI models in endoscopic colonic polyp detection and classification and compare them with doctors with different experiences.
Nanotechnology Could Help Us Cure IBD (Medscape)
University of Wisconsin-Madison researchers are developing nanoparticles — particles measuring between 1 and 100 nanometers (one-billionth of a meter) — designed to treat IBD, including Crohn’s disease and ulcerative colitis.
Microbiome Home Test Kits Are The Wild West Of Gut Health (Inverse)
Direct-to-consumer gut microbiome tests are increasingly popular, but experts argue they may do more harm than good.
Iterative Health Partners with Gastro Health to Accelerate Clinical Research in Gastroenterology Through Artificial Intelligence (Business Wire)
The partnership brings Iterative Health’s AI Recruitment technology to Gastro Health to help identify patients for clinical trials.
December Issue of The American Journal of Gastroenterology (AJG)
The December issue of The AJG introduces new hypothesis on gravity’s role in IBS, Multi-Society findings on diversity, equity, and inclusion, and plan for GI in mitigating climate change.
4 Key Predictions for Health Care in 2023 and How to Respond (American Hospital Association)
Based on forecasts, provider organizations can expect significant evolutionary changes in optimizing patient engagement, the expanding role of retail clinics, and upheaval in venture capital funding for healthcare startups.
Capsule Endoscopy Prep in the Colon Low-Volume Regimens Work Fine (GI & Endoscopy News)
For bowel prep before colon capsule endoscopy, two low-volume regimens were as effective or superior to a standard high-volume prep according to a study.
New advances in surveillance and screening in Barrett’s esophagus (AGA)
AGA provides guidance for using existing methodologies as well as emerging and novel screening technologies.
Risk stratification may improve NAFLD intervention in obese, overweight populations (Healio)
Results from a meta-analysis underscored the need to improve understanding of nonalcoholic fatty liver disease burden and management in at-risk individuals who are overweight and obese.
An Overview of Guideline Updates for IBS-C (ReachMD)
Dr. Peter Buch dives into these guideline recommendations with Dr. Arnold Wald, a Professor of Medicine at the University of Wisconsin.
metaMe Health Named to the 2022 CB Insights Digital Health Top 150 List (HCP Live)
metaMe Health is recognized by industry leaders worldwide for their achievements in pioneering prescription digital therapeutics (PDTs) for gastrointestinal conditions.
Standards for Endoscope Safety And Reprocessing (GI & Endoscopy News)
Experts from across the country have distilled multiple sets of guidelines into a new standard of care for endoscope safety.
Gastro Health and Lynx.MD Partner to Create the Largest Repository of Real-World Clinical Data in the Gastroenterology Space (Gastro Health)
The collaboration creates a repository of real-world evidence that can be used for research that improves the quality of GI care.
Physician leadership is needed now more than ever (Medical Economics)
Today’s healthcare environment presents outstanding opportunities for physicians to develop lasting improvements in care delivery by demonstrating and providing leadership.

More Hot headlines in GI

Apollo-Backed GI Alliance Names Katten Partner as Legal Chief (Bloomberg Law)

5 gastroenterology ASCs to know (Becker’s GI & Endoscopy)

Dr. James C. Hobley receives award from the American College of Gastroenterology (KTBS)

Boston hospitals booked solid for colonoscopies (Boston 25 News)

Scoop: Commons Clinic clinches $11M for specialty care (AXIOS)

ASGE, Surgical Science collaborate on GI endoscopy simulation-based curricula (Healio)

Dayton VA only Ohio VA using artificial intelligence to find colorectal cancer (Dayton Daily News)

NAFLD ‘not fit for purpose’: Experts debate impact of changing name vs. definition (Healio)

Subcutaneous Infliximab And the FODMAP Diet (GI & Endoscopy News)

Santa Clara patients wait 6+ months to be seen by pediatric GIs, internal memo alleges (Becker’s GI & Endoscopy)

It’s Not Just The Elevator — Endoscope Channels Are Dirty, Too (Single-Use Endoscopy)

The Academy for Surgical Coaching and SAGES Pilot First-of-its-Kind Coaching Program for Gastrointestinal and Endoscopic Surgeons as They Transition to Practice (PR Newswire)

Videos: Interviews with GI Leaders  (Scope Forward Show/NextServices)

COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
10 Dec 2022

Curated GI articles December 9th, 2022: Self-powered gut sensor | Virtual yoga for IBS | GIThrive app acts as patient intake service

Curated GI articles December 9th, 2022:
Self-powered gut sensor | Virtual yoga for IBS | GIThrive app acts as patient intake service
GI payments face steep cuts unless Congress acts (AGA)
GIs who treat Medicare patients will face cuts up to 8.5 percent in the new year unless Congress intervenes.
GI pay in 2022: 10 statistics (Becker’s GI & Endoscopy)
Gastroenterologists earned $453,000 on average during 2022, with compensation fluctuating based on practice setting and length of employment.
AI in GI Needs to Catch Up to Other Fields (GI & Endoscopy News)
As gastroenterology continues to incorporate artificial intelligence strategies, it will be important to learn from the experience of other disciplines that are further advanced in their AI applications.
Iterative Health Named to the 2022 CB Insights’ Digital Health 150 List (Business Wire)
Iterative Health, a pioneer in the application of advanced AI tools in GI has raised $195M in funding to date. Dr. Jonathan Ng (Founder & CEO, Iterative Health) was recently interviewed on The Scope Forward Show. Watch the interview here.
Algorithm Improves Predictions of Recurrent CRC, Provides Another Tool for GIs (GI & Endoscopy News)
An algorithm developed by researchers at Mayo Clinic successfully improved predictions of colorectal cancer recurrence in a recent multinational study.
Innovative Self-Powered Ingestible Sensor Opens New Avenues for Gut Research (Newswise)
UC San Diego Researchers develop a self-powered ingestible sensor system designed to monitor metabolites in the small intestine over time.
Virtual care technology, clinical team tackle digestive health challenges (Healthleaders)
The GIThrive app by Vivante Health acts as a patient intake service, referring users to Vivante Health’s virtual-based clinical team or to brick-and-mortar physicians.
Robotic versus laparoscopic surgery for middle and low rectal cancer (ScienceDirect)
The study aims to compare surgical quality and long-term oncological outcomes of robotic and conventional laparoscopic surgery in patients with middle and low rectal cancer.
Physicians React: Loving, Loathing Working for a Health System (Medscape)
Working for a health system or other medical employer has its perks and downsides for physicians, as per a Medscape survey.
What Every GI Provider Should Know: Dietary Guidelines Update For IBS (GI & Endoscopy News)
In this video, Carolyn Newberry, MD, and Jennifer Katz, MD, discuss salient points from the clinical practice update, homing in on practical recommendations for clinicians treating IBS patients.
AnX Robotica Partners with GastroGPO, a Specialty Networks Company (Newswise)
The addition of the NaviCam MCCE will allow GastroGPO members to offer a sedation free, minimally invasive diagnostic test to visualize the esophagus and stomach.
The road to Oz: 5 ways physicians can finally reach the promised land of value-based care (Medical Economics)
Over a decade after being promised change was on the way, physicians and other providers can start taking tangible steps towards a better system.
Managing Postoperative Crohn’s Disease: Key Therapeutic Approaches (ReachMD)
Dr. Peter Buch dives into this topic with Dr. Robert Battat, the Director of the Center for Clinical and Translational Research for Inflammatory Bowel Disease at the University of Montreal.
Virtual yoga program appears to improve IBS symptoms, fatigue, stress (MDedge)
An online yoga program appears to be effective, feasible, and safe for patients with irritable bowel syndrome (IBS), according to a new report.
Telemedicine increases access to care and optimizes practice revenue (MDedge)
The prevalence of gastrointestinal illness, the size of the market, and the growing difficulty in gaining access to care makes it natural to consider whether virtual care may benefit patients and GI practices alike.
Mental Health, Psychiatric Comorbidities in IBD, Crohn Disease (Consultant 360)
In this podcast, Charles Bernstein, MD, speaks about how psychiatric comorbidities that occur in patients with Crohn’s disease differ from other IBD disorders, the collaboration necessary within the clinician care team managing patients with IBD.
5 gastroenterologists to know (Becker’s GI & Endoscopy)
A list of five gastroenterologists to know, as compiled by Becker’s Healthcare.
The Top 5 Healthcare Trends In 2023 (Forbes)
The article provides an overview of what the most important trends of the next 12 months will be.

More Hot headlines in GI

Shineco granted US patent, FDA marketing approval for fecal specimen sampling device (Healio)

Ohio Gastroenterology Adds Digital Pre- and Post-care Engagement Tools Through Orbita Platform (PR Newswire)

AGA ‘applauds FDA’ for first approved fecal microbiota biotherapeutic (Healio)

CMS gives providers breathing room on looming advanced good faith cost estimates (Fierce Healthcare)

Olympus Announces EMEA Expansion of Exclusive Partnership with EndoClot Plus, Inc. (PR Newswire)

Dr. Hau Liu Joins Vivante Health as Chief Medical Officer (PR Newswire)

4 gastroenterology ASCs built or proposed in 2022 (Becker’s GI & Endoscopy)

Walgreens Has a New Offer That’s Even Better Than Amazon (TheStreet)

Videos: Interviews with GI Leaders  (Scope Forward Show/NextServices)

COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.