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AmalgamRx, a newly unstealthed company founded by WellDoc founders Ryan Sysko and Dr. Suzanne Clough, has received FDA clearance for iSage, an insulin titration algorithm.

“One of the big challenges with insulin is that it’s scary for patients, they don’t necessarily want to go on it,” Sysko told MobiHealthNews. “So we wanted to find a way to help them optimize their insulin regimen and get to the right dose of insulin. Fifty-one percent of people who start on insulin don’t get the right dose and they don’t get their A1C in target, and we felt like there was a massive opportunity to leverage technology to deliver self-management support, education, and behavioral support to get patients to use the right therapy.”

iSage is a prescription-only patient-facing iOS and Android app that works in conjunction with a web portal used by the doctor. The doctor sets target levels for insulin based on the patient’s glucose levels. Then the algorithm takes over. Patients can enter their blood glucose levels and iSage will change their insulin dosing levels based on the doctor’s plan and the entered values. Currently, doctors start patients on a very low dose for safety reasons and often can’t update that does until the patient’s three month checkup, Sysko said.

“In addition to just a number, we’ve started to build this feedback and education and support for a patient that will sort of help them on their journey,” he added. “So week one might be all about setting expectations, what should they know, insulin basics. Then we might focus on insulin administration. There are trivia questions and proprietary videos that we’ve developed. All to make it a little less scary for the patient as they start the drug so we can hold their hand.”

AmalgamRx isn’t aiming to compete with the many diabetes management tech companies out there, including Sysko and Clough’s previous company WellDoc. Instead, through partnerships, APIs, and SDKs, they intend to augment services like WellDoc, Livongo, and mySugr, which Sysko refers to as “operating systems” for diabetes.

“This for us is a great area for those people who are focused on creating the operating system for diabetes to say ‘Look you can just plug us in, you don’t have to go through those regulatory hurdles to get insulin titration cleared, you don’t need to do that development work, we can accelerate your time frame by allowing you to plug in our APIs and SDKs,” he said.

Sysko and Clough have a lot of plans for the future. While the FDA-cleared algorithm works with every insulin on the market, they’re also working on new algorithms for combination therapies from Sanofi and Novo Nordisk as well as mealtime algorithms.

Integration is another area of focus for the future, whether that’s integrating with physician workflow tools or with connected glucometers, CGMs, or smart insulin pens.

“Dose capture will be an important part of titration, and we sort of expect to integrate those dose capture devices into our application in the same way that we’re working on integrating blood glucose meters and CGM via Bluetooth,” Sysko said. “At the end of the day patients are starting to expect that all of these devices can talk to one another.”

Catalia Health, which makes an AI-powered patient engagement robot called Mabu, has raised $2.5 million in a new round led by Khosla Ventures. Additional investments came from new investors NewGen Capital and Macnica Ventures and existing investors Q Venture Partners Limited, InnoLinks Ventures, Abstract by Flight.VC, DeNA and Lucky Capital. This brings the company’s total funding to $3.75 million.

“This investment enables us to hit two major milestones: roll out Mabu to our first patients and obtain significant data that will show the benefits of our platform to patients and customers,” Catalia CEO Dr. Cory Kidd said in a statement. “We’re pleased to have Khosla Ventures, one of the most prominent healthcare technology investors, back to lead our second round of funding.”

Mabu is a tablet built into a sculpted, stylized body that’s meant to serve as a personal healthcare companion for patients at home, particularly elderly patients. The robot has conversations with patients via the tablet every day and adapts to their particular behaviors and preferences. It can remind patients to take medications, ask how they are feeling, and contact their caregiver if need be. It can also send them text message reminders during the day.

Currently the company is testing Mabu as a medication adherence aid in ongoing pilots with pharma companies, healthcare systems, and home health organizations.

“NewGen Capital is excited to join the Catalia Health team because we see great potential in utilizing artificial intelligence and natural language processing to improve patient care and monitor and increase pharmaceutical adherence,” Homan Yuen, managing partner of NewGen Capital, said in a statement. “We firmly believe technology can be used to enhance quality of life and this is a clear example of that.”

The company will use the funding to build out and deploy its care management system for three different conditions. The company plans to have the first two rolled out by this summer.

Boston’s Partners HealthCare has entered into a four-year partnership deal with Persistent Systems to build clinical decision support systems for various departments throughout the hospital. The two groups will work together to develop an open sourced platform based on SMART and FHIR.

“Making innovative clinical tools available to our physicians at Partners and across the country relies on strong collaborations between academia and industry,” Dr. Anne Klibanski, chief academic officer at Partners HealthCare, said in a statement. “The co-development of this platform should yield a new tool that integrates applications directly into the clinical workflow — ultimately improving patient care.”

Rahul Patel, executive vice president of digital at Persistent, explained that in most parts of the hospital, clinical decisions are made by the doctor according to a set of rules. Persistent and Partners will work together to augment those rules, and the doctor’s intuition, with a learning algorithm tapped into hospital datasets.

“What we have learned working with Partners is that cardiologists [for instance] can benefit a lot by having a much deeper knowledge of comparative information relating to similar type of patient or a similar type of treatment that has been applied to the patient, and based on that kind of information a cardiologist can make a much better decision,” Patel said.

One thing that makes this partnership interesting is how longterm and broad-reaching it is. Rather than doing a brief pilot, the two companies are committing up front to at least a four-year relationship.

“Essentially a platform will really be measured only after creating dozens of apps that will be delivered on that platform,” Patel said. “Therefore it is not a one-time idea we are trying to bring out and decide [if it works for Partners], the kind of scenario that is typical with a pilot. We think with the ecosystem we are creating, it will require longterm commitment from both sides to continue to measure.”

By creating an open-source platform, Persistent and Partners can avoid problems hospitals sometimes have implementing and scaling pilots.

“For each of these problems, if you were to put together a data platform to really do this analysis it’s very time intensive and very expensive for an IT department to solve,” Patel said. “So the idea of the platform is critical to be able to provide many of these use cases from the same system. That’s why we are choosing this starting point where we are providing immediate value to a specific department and a specific set of patients, but the idea is a different problem that needs to be solved [later on] will be able to leverage the data that’s been brought together.”

Boston Children’s Hospital is the latest to tackle the problem of continuity of care between a patient’s doctor and any emergency room or urgent care center they might find themselves in. And they’re testing the technology, from startup Position Health, in some of their smallest and most high risk patients.

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