The Longevity

After 2 Years in Stealth Mode, Google Glass Unveiled its Enterprise Edition

Alphabet initially launched Google Glass as a consumer wearable that by most assessments spectacularly crashed and burned. Last week, they publicly unveiled the Enterprise Edition, although it turns out a number of mHealth companies have already been quietly testing the smartglasses in healthcare settings through Google’s Glass at Work program.

Google’s unveiling last week of Glass EE might have been big news in some circles, but healthcare providers have been working with mHealth companies like Augmedix and Pristine for some time now on the second version of the smartglass model.

If anything, experts say, the publicity surrounding Glass EE might bring health system and entrepreneurs out of the shadows to show off what has been working all along for clinicians.

Augmedix CEO Ian Shakil reports that during this quiet development period, “there was no shortage of ideas” on how to use Google Glass EE.

[Augmedix]…has received some $40 million in funding and partnered with a handful of large health systems over the past year on testing and using the newest version of the smartglasses in clinical settings. “If anything, I think you’re starting to see a consolidation of ideas” as healthcare refines its uses for the wearable.

Michigan-based Trinity Health, [to look at another example], is getting ready to test the new Google Glass EE….as a mobile clinical assistant for home health workers. The health system is partnering with swyMed, a developer of video visit technologies, to test the smartglasses in home visits by Loyola University Health System practitioners in Maywood, Ill.

…The high-tech visits will be overseen by nurse leaders or practicing physicians, with the goal of determining whether the smartglasses can improve care coordination and foster better collaboration between home-based patients – such as those with chronic conditions – and their care teams.

[Capers Harper, Loyola’s manager of virtual medicine] calls the smartglasses “just another tool in the kit to bring back the house call…Caring for patients in their own homes is rewarding and educational for students in the healthcare industry…It helps them relate and empathize with patients and ensures that care transitions are smooth and medications are taken correctly. This could improve the chance of positive outcomes for patients with complicated health histories.”

What has been improved in this latest version of Google Glass?

Aside from a sleeker appearance, Google Glass EE offers improvements in what Shakil once called the “not-so-sexy areas,” like battery power, CPU performance, Wi-Fi capability and software upgrades.  

Shakil says Google Glass EE still has battery life issues, especially since Augmedix views the digital health device as an all-day-every-day clinician’s companion, offering instant access to data when and where the wearer needs it. He hopes Google will continue to work on refining battery life and wireless capabilities.

“Doctors are really, really hard to please, but they see a lot of value in [smartglasses] when they’re standing in front of the patient,” he told mHealthIntelligence.com during an interview this past January. “It allows them to have a dramatically more humane conversation with patients and saves two to three hours a day, maybe more, in administrative work.”

That point may be seen in Augmedix’ business arc. The company has secured roughly $40 million in new funding over the past year, and Shakil says they’ve doubled the number of health system partners in that time as well, from six to 12.

“The market is definitely there,” he said.

And it may grow, now that Google Glass EE has come out of the shadows.

4 Veterans of FinTech “Company Building” Launch Lab for Digital Health Startups

The four founders of the new Berlin-based Heartbeat Labs aim to build “pioneering healthtech companies,” according to its website.

[The] new company builder by HitFox Group…will launch up to five digital startups a year.

It will back three to five startups working on health tech solutions with seed funding between €500,000 and €5 million. It will launch its first company by the end of August.

Heartbeat Labs was founded by Jan Beckers, Hendrik Krawinkel, and Eckhardt Weber, who previously founded the fintech company builder FinLeap, which raised €39 million earlier this week.

“While medical therapies are advancing steadily, not enough progress has been made in making healthcare more data-driven, efficient and affordable,” said Jan Beckers, managing director, on the decision to establish the new company builder.

“We look forward to leveraging our expertise to support the digitization of existing healthcare players and to bringing new business models to this market.”

Eckhardt also believes this is the right moment to jump into the digital health sector in Europe.

The European digital health sector is starting to catch up with the US, said Eckhardt. “We believe this is the right time to invest in healthcare: Changing regulations in Europe is opening up the markets. Technological capabilities are developing quickly,” he said.

Heartbeat Labs will assist startups on a business and product development level and help them prepare for entering what is a heavily regulated market. The program is supported by a board of medical experts.

Before You Go in Search of Funding, Make Sure You Avoid These Three Red Flags

Mark Gilbert, founder and CEO of MBS Accounting Technology & Advisory, recently contributed a post to MedCity News on some of the pitfalls start-ups fall into which “send investors running”.

Many health tech startups blame the economy when fundraising efforts go awry. Yet more often than not their failed fundraising boils down to the basics of business. These digital health entrepreneurs are overlooking areas of their business that investors want to scrutinize.

 Investors are scared away when the books are a mess, even when a startup has a unique idea. As a result, many startups never get their ideas discovered or funded. Today’s private investors, seed funders and angel investors – want more detailed reporting. They’re more astute to burn rates and detailed projection models, relying less on tax statements.

Aside from a good business idea, says Gilbert, investors want to see solid financials and business practices.

Red Flag #1: Using Excel as an accounting system

My company works with many startups and we continually see their founders using Excel for accounting. Running financials on an Excel document is a tedious practice, inadvertently leading to basic human error; just one incorrect manual input leads to the distortion of numbers that are important in company decision-making.

Using error-prone spreadsheets communicates the wrong message to investors. This practice is viewed as unprofessional, especially since it is not compatible with scaling a business. When the company scales, founders will spend too much time focusing on manually updating and linking spreadsheets.

 As the company’s Excel accounting system becomes more complex over time, this knowledge is not easily shared with new employees, let alone investors. It is increasingly hard to understand how the system of spreadsheets fits together.

 There is a quick fix — invest in a professional accounting interface system. Programs like QuickBooks Online and Xero will prepare any health tech startup from day one. An accounting system is more efficient and allows a startup to scale more quickly.

Red Flag #2: No due diligence reporting

Here is why you need that accounting interface. It will help you quickly generate reports. As soon as a pitch is made to investors, they will want the startup to show due diligence. This validates that a startup has an organized business model and is ready for capital investment.

The best way for a startup to show due diligence is with financial data, yet most startups do not have anything on hand other than bank statements and spreadsheets. Investors want to see a bottom-up financial forecast and a detailed analysis of cash flows to back up projections.

Potential investors will want to see departmentalized sales reports, enhanced expense reports and salary reports. An operating expense plan based on actual numbers is not only more concrete but also more realistic, two traits investors are looking for. These documents will show investors that the startup has a real understanding of its cash flow, revenue and variable expense projections.

Red Flag #3: No competitive research

Most startups are internally-focused and do not check industry comparisons before heading to investors. A startup will fail to raise money if it does not have as much knowledge of main competitors as it does of itself. Albeit, a startup with a new concept may not likely have the advantage of competitive research but a disruptive startup without peer benchmarking is a red flag

All investors will do an industry comparison. They will analyze all competing firms on similar revenue lines and compare the projections of their potential investment to existing companies. Investors will check to see what competitors are paying for supplies; if a startup is off the charts on variable expenses compared to competitors, it will need to come into the meeting with an explanation.

For this reason, startups are expected to know what industry comparisons will show on items like sales, revenues and expenses. This information is readily available with software like Qvinci.

Disorderly books cause potential investors to lock up their wallets and throw away the key. It’s not just because it looks unprofessional; it’s because every piece of a business is entwined with finances. All health tech startups can better prepare themselves right now for successful fundraising by instituting professional accounting and competitive research.

Two Scenarios for FDA’s New Approach to Digital Health

In a guest post for MedCity News, Leland Brewster of health innovation services company Healthbox considers two possible ways the FDA’s new tack on digital health might shake out.

In June, the Food and Drug Administration announced an initiative to ramp up regulations in the digital health space. The announcement comes on the heels of the 21st Century Cures Act which, among several proposals, starts to outline the role of FDA in overseeing digital health solutions.

While the recent report remains vague regarding specific regulations, the team at Healthbox has outlined two possible regulatory scenarios and the potential implications of each on digital health solutions:

Scenario 1: FDA opts for a light touch and modest regulatory barriers

In this scenario, FDA may evaluate whether solutions provide enough functionality (for instance, can I use it?) and basic value (does it help me?) while preventing patient harm (would a doctor recommend it?).

Clearing this hurdle would be similar to a newly developed iPhone app being approved for sale in the App Store. We don’t think this scenario would have a particularly significant impact, as most subpar solutions already lack market traction and fail without reaching a major healthcare stakeholder be it provider, payor, investor, and others.

If anything, this modest regulation might actually benefit patients who interact with direct-to-consumer digital health solutions by weeding out deficient products with inappropriate or even harmful content.

Scenario 2: FDA requires a high degree of clinical validation and outcomes

Alternatively, FDA could choose to significantly up the standards by requiring solutions to prove their value — their ability to decrease mortality, improve patients’ quality of life and other outcomes — before being allowed to be sold.

A move like this would have a big impact on the market. Perhaps most notably, the time-to-market and costs to launch digital health solutions would sharply increase as companies are forced to navigate the approval process.  Remember that FDA has historically been overwhelmed with the volume of digital health apps for review.

While this raises the bar for companies, an official government stamp-of-approval may increase the likelihood and speed with which payors and providers adopt these solutions once they’re actually available. As a case study, leaders in the digital therapeutics space such as Omada Health and Pear Therapeutics have proactively worked to clinically prove the value of their products, despite the added costs, and appear to be reaping the benefits.

If the FDA opts for Scenario 2, says Leland, it will inevitably stifle investment in digital health startups and therefore the pace of innovation. However, there are moves the FDA could make to compensate, at least partially, for this slow-down. For example:

--Instituting government-sponsored funding, much as the NIH does for drug discovery research. It would probably be comparatively less expensive but the paradigm would remain the same. This would enable digital health technology companies to skip early stage venture investors and apply for grant funding instead.

--Increasing the value of the agency’s approval by tying it to CMS reimbursement. Unlike 510(k) clearance for medical devices or CLIA certification for diagnostic laboratory tests that do not guarantee reimbursement, this approach could help the high-quality vendors that receive regulatory approval to more easily grow and succeed.

No one yet knows which approach the FDA will take to regulating the explosion of digital health products, particularly all the software, but “all industry stakeholders are watching closely,” says Leland. And he also has a request for the agency, should they take the higher regulatory path.

Should they opt for more significant regulation of digital health, we urge the agency to consider simultaneously rolling out programs to offset the decline in available early-stage venture capital that could result with a higher regulatory bar.

Whether this takes the form of expanded grant funding, a public investment vehicle, or something else altogether would depend on the appetite of the current administration. Regardless, the goal should be to continue driving forward the innovation engine that is digital health rather than discouraging growth with overly burdensome regulations.

 

FDA Commissioner Announces Pilot for Expediting Approval of Digital Health Products

Just a few weeks into his role as the US Food and Drug (FDA) Commissioner, Scott Gottlieb has announced that providing clear guidance on digital health regulation--and expediting approval for low-risk digital health products and services--is a priority for the agency. (Read his original letter on FDA's blog).

[Late last week], Gottlieb...announced an upcoming pilot program that would create a third-party certification program under which lower-risk digital health products could be marketed without FDA premarket review and higher-risk products could be marketed with a streamlined FDA review.

The pilot, part of a new approach to regulating digital health tools, would help to certify, according to Gottlieb, whether a company "consistently and reliably engages in high quality software design and testing (validation) and ongoing maintenance of its software products. Employing a unique pre-certification program for software as a medical device (SaMD) could reduce the time and cost of market entry for digital health technologies."

This effort to provide clearer guidelines and expedited processes for digital health products is all part of FDA's implementation of the 21st Century CURES Act that was passed in December at the tail end of the Obama Administration. The Cures Act, passed with an overwhelming majority in both the House and the Senate, aims to "boost funding for medical research, ease the development and approval of experimental treatments and reform federal policy on mental health care," according to a Washington Post article at the time.

"...FDA will provide new guidance on other technologies that, although not addressed in the 21st Century Cures Act, present low enough risks that FDA does not intend to subject them to certain pre-market regulatory requirements," Gottlieb wrote in FDA’s Voice Blog.

FDA also will provide guidance clarifying its stance on products that contain multiple software functions and which currently fall outside FDA regulations.

The push into digital health comes as Bakul Patel, ‎associate center director for digital health at FDA, recently told conference attendees that guidance related to software as a medical device, and a new dedicated unit to digital health are coming to FDA’s Center for Devices and Radiological Health (CDRH). 

(See our coverage of FDA's new digital health unit here).

Gottleib also touted the role of a universal method for collecting post-market data on digital health products and using that data in turn to expedite new or evolving product functions.

"For example, product developers could leverage real-world data gathered through the National Evaluation System for health Technology (NEST) to expedite market entry and subsequent expansion of indications more efficiently ... The Medical Device Innovation Consortium (MDIC), a 501(c)(3) public-private partnership, is serving as an independent coordinating center that operates NEST. In the coming weeks, MDIC will announce the establishment of a Governing Committee for the NEST Coordinating Center comprised of stakeholder representatives of the ecosystem, such as patients, health care professionals, health care organizations, payers, industry, and government," Gottlieb wrote.

NEST’s fully operational system is expected to come by the end of 2019.

The Longevity Network’s Guide To Pitching Digital Health & Caregiving Investors

Entrepreneurs are compelling—captivating even—because of their passion, their willingness to take risks, and their backstory of how they came to be so passionate and willing to take risks. So everything you’ve read about 1) making your pitch aspirational; 2) being creative in capturing “the problem” you’re trying to solve and 3) adding a personal story about why you care about this problem—those are all good tips. You want to convey the entrepreneurial persona when you have those few minutes of an investor’s time.

However, the aura is not usually enough, in particular, for investors experienced in the health tech and caregiving space for the 50+ market. This sector is uncommonly complex. To name just a few reasons: we have both public and private payers, enormous variety in providers, convoluted regulations dictating the behavior of payers and providers and a whole slew of shifting dynamics among aging but capable older adults and their paid and unpaid caregivers (the latter of which often bring geographical distance and complicated family dynamics into the picture).

So what else do you need to make sure you convey in a successful pitch? Here's a curated list pulled from real feedback investors gave entrepreneurs after hearing their pitches.

THE BASICS

Even if you’ve successfully conveyed the entrepreneurial aura, your potential investor can still be left wondering about the basics: who is the user and who is the buyer? These fundamentals of your business plan should not be left to clarify during the Q&A, so when practicing your pitch, make sure you clearly convey who benefits and who pays.

THE DETAILS

Time is of the essence when developing your pitch, so the details of the business plan cannot always be included, but make sure you are fully conversant in those details should any questions come up afterwards. For example, here are a few questions coaches asked during AARP’s recent Innovation@50+ LivePitch event in Mountain View, CA.

- What does it cost for consumers now and what will it look like when you add b2b? What problem are b2b customers most interested in solving for?

- How do you provide value back to the payers?

- How many units do you need to sell to be profitable

- What is the lifetime value of a customer?

- What if your user varies their behavior, e.g., doesn’t take their meds at home one day?

- Tell me more about the data integration with your app.

CUSTOMER ACQUISITION & SCALING UP

If you haven’t yet heard of CAC, now is the time to learn about it because every investor worth their salt will be asking. Cost of (Customer) Acquisition is important for every startup but particularly for startups whose product is software and / or if your target customer is a payer or provider because those sales cycles are notoriously long.

If you aren’t tracking CAC yet, start now and come to any future pitch armed with data.

Here are some versions of the way you may be asked this question:

- How does acquisition happen?

- How do people find you?

- What data do you have on the cost of acquisition—i.e., growth cost versus cost of maintenance?

- How do you integrate into these health systems specifically, i.e., who do you target and how do you locate the decision makers?

Closely related to acquisition cost questions are questions about the costs involved in scaling up? You will want to be conversant how hiring, training, and marketing play into your business.

You may hear, for example:

- Would you need to build a fairly sizable marketing engine to scale?

- Have you calculated how large a sales team you would need to hit target customer numbers?

- What percentage of your scaling up operation is human-driven and what percentage is based on marketing campaigns?

- Do you have any organic referrals happening yet or are you generating all your own leads?

TEAM

This is a brief lesson: investors know that execution of the business plan is one of the top 3 or 4 factors in the success of startup. Being the impassioned, visionary founder is compelling, but don’t forget to highlight the domain expertise, technical abilities or marketing savvy of your fellow team members. Any previous success with a startup venture is particularly good to highlight.

STRATEGIC PARTNERSHIPS

Having a plan in place for building strategic partnerships may be what separates the unicorns (or even reasonable success stories) from the zombies doomed by an unforgivingly high CAC. Every digital health or caregiving tech startup faces an uphill battle, and investors know it. The space is inefficient and the market is enormous—which is to say, ripe for disruption—but breaking in is still tough and many a startup with a great idea and a talented team has run out of cash before achieving that market traction crucial to securing Series A or even sufficient seed funding.

But don’t show up with a vague reference to how you will soon begin developing those strategic partnerships. Have a concrete list in mind of who they might be and, importantly, what it would mean to be “partners”.  Would they be:

- Distribution channels?

- A marketing platform?

- Willing to pay for kind of data you will be collecting or producing as a by-product?

PILOTS

Pilots for digital health and health IT products have become very popular in recent years. Brookdale Senior Living Solutions, one of the largest operators of senior care facilities in the country, has even developed an Entrepreneur-in-Residence program. (See our in-depth exclusive of the program here).

It’s a great idea to highlight any past or current pilots during a pitch, but because they have become so prevalent, make sure you are prepared to provide plenty of detail so it conveys your skillful execution.

Questions you may hear from investors:

- What have been your biggest learnings from consumer-facing pilot?

- What was the number 1 request you received from your customer during your pilot?

And crucially,

- Is there anything in place to roll this pilot into a paying contract automatically, if say, a certain benchmark is achieved?

Investors will love to hear that you have negotiated that conversion to paying customer ahead of time, because they have already seen too many startups die a slow cycle of “death by pilot”.

DIFFERENTIATION FROM COMPETITORS

This key indicator should arguably be at the top, included under “the basics”. Any smart investor will want to know as much as possible about the competitive landscape, and it may be up to you to educate them on it, depending on how niche your product or service is.

Again, this is not a topic to leave for the Q&A—it should be defined and then reinforced during your pitch.

This is particularly true if you are attempting to break into an already crowded field. As one judge from LivePitch told a contestant: “be stone cold on your differentiator and your creativity, because there are a LOT of these on the market”.

Here are a few ways to frame it:

- How do you differentiate from competitors?

- What competitor scares you the most?

- Do you have anything proprietary—patents or trademarks—that would secure your market differentiation?

Pitching has become its own art form, so the competition is stiff. The better prepared you can be shows not just that you value the time and expertise of the investor but also, that you understand your business model from top to bottom. And that—reinforces the entrepreneurial mystique.  

Report: Digital Disruption in Healthcare is $8.7 Trillion Global Juggernaut

This month, Business Insider released a teaser of some of the top findings from its new report on digital disruption in healthcare. Its first finding? This juggernaut is now impossible to stop.

Whether patients and their doctors are ready or not, though, digital disruption in health care will only accelerate in the years ahead.

The scope of the report is comprehensive.

In a new report from BI Intelligence, we analyze digital disruption in health care, looking at clinical operations and the role of electronic medical records. We identify the expanded scope of medical care and how patients will use health devices in their everyday lives, as well as survey the possible impediments to the digitization of health care in regulation, workflow resistance, and privacy concerns.

Here are some highlights from BI Intelligence’s report:

  • Digital is already disrupting health care in a number of sectors; electronic health record use is climbing and will near saturation as third parties figure out new and better ways to link and comb through that data.
  • Companies are developing all sorts of tools and equipment that doctors and nurses will use to gain new and greater insight into their patients, from connected scales to smart beds, and even augmented reality (AR) glasses.
  • There are clear hurdles to disruptive digital technology in health care, including regulation, staff buy-in, and privacy concerns. However, these barriers are starting to fall as the benefits of connected devices grow more apparent. 

The full BI Intelligence report promises to:

  • Explain the role of digital technology in medicine, and how it is and will continue to disrupt health care.
  • Provide an overview of disruption in clinical care, the health records space, and care in everyday life.
  • Analyze how the growth of digital health technologies will save time and reduce costs for the health care sector.

The full report can be Purchased & Downloaded or you can learn more about subscribing for an all-access pass to BI Intelligence.

New Brunswick Launches Canada’s First Innovation Hub to Support Tech Solutions for Aging

The Canadian province of New Brunswick recently launched the country's first innovation hub focused on tech solutions for the aging.

The New Brunswick Health Research Foundation (NBHRF), in collaboration with the AGE–WELL Network of Centres of Excellence (NCE), is launching Advancing Policies and Practices in Technology and Aging (APPTA), an innovation hub dedicated to building tech that supports healthy aging.

AGE-WELL NCE said the APPTA hub, which officially opened on May 16 in Fredericton, will focus mainly on developing technologies and solutions for policy, program, and service challenges in the field of technology and aging. The hub is meant to allow Canadians to benefit from emerging technologies that foster independent living and improve the quality of life for aging adults.

The goal is to help entrepreneurs get to market with their products and services designed to support healthy aging.

Lisa Harris, New Brunswick’s minister of seniors and long-term care [said], “We are delighted to be the host province for a hub that will be a national resource for policymakers, researchers, clinicians, and others working to implement novel technologies that will improve the health and wellbeing of older Canadians and their caregivers.”

The APPTA hub will help entrepreneurs take their ideas to market by connecting them to end users, policymakers, and service providers. AGE-WELL NCE said it will also bring training opportunities for graduate students and post-doctoral fellows from the field of technology and aging. AGE-WELL and NBHRF will jointly fund the salaries of four individuals annually.

“This hub will promote knowledge-sharing and effective transfer of needed technologies right across Canada," [said] Bruno Battistini, president, CEO, and scientific director of NBHRF and a co-sponsor of the hub.

Conversa’s Doctor-to-Patient Platform Gets $8M Round of Funding

San Francisco-based Conversa Health will use the funds to make improvements to the platform and to scale up its operations in Portland, OR.

The Series A round was led by New York-based Northwell Ventures and also included Epic Ventures, Healthgrades, and other existing investors in the company.

Conversa’s Portland office was established in 2012 and works on the company’s technology, engineering, product development/management and operations functions. The company currently has ten employees based there, with plans to grow the office after the recent funding round.

The company's biggest personnel addition to the Portland office comes from Web MD.

Last month, the company added its new VP of Operations, digital health vet Becky James, to the office. James formerly spent twelve years in leadership positions at Web MD’s Portland office, most recently serving as the company’s senior director of client delivery.

The company's goals are familiar: improve patient engagement and health outcomes and lower costs.

Conversa offers more than 50 automated “conversation programs,” platforms that allow care teams to communicate with patients. The platforms are each tailored to different conditions, including asthma, congestive heart failure, diabetes and joint replacement.

SilverRide Offers Mobility Solutions for Bay Area’s Aging, Disabled

San Francisco-based SilverRide was founded in 2007, with a mission to meet the transportation needs of older adults with ambulatory or other limitations.

“When you get a ride from us, it’s a lot more than a ride,” said Jeff Maltz, who launched SilverRide in 2007 after hearing about older adults facing transportation problems. 

Drivers for SilverRide undergo background checks and random drug testing, but they also get training in transporting people with special needs of all kinds, physical and cognitive.

“The truth is, it’s a little easier to help someone in a wheelchair,” Maltz said. “If you’re helping somebody with a cane or walker, there’s a higher risk of fall.” SilverRide calls the service “door-through-door.” Drivers don’t pull up to the curb and wait for the passenger to hop in. Instead they provide a safe escort from indoors to the car and back indoors again at the destination.

Drivers, who get liability insurance coverage from SilverRide, also shuttle customers to and from medical procedures that involve anesthesia, where doctors recommend against patients driving themselves.

SilverRide staff additionally develop the profile of each rider when they sign up, allowing for more individualized service.

[For example, the] company... gathers information about whether there are steps outside clients’ homes, how to reach their emergency contacts, how often a client likes to go out and where he or she likes to go. The company promises to keep those details and preferences on file and confidential.

...For an additional fee, SilverRide drivers will stay with clients who can’t or don’t want to be on their own, accompanying them to games, shows and other events. Those costs range from $45 to $85 an hour. The company says its drivers spend 70 percent of their time in that capacity.

Like most transportation services designed for older adults, SilverRide does not presume smartphone usage.

Riders can summon SilverRide with a phone call or by email, convenient options for those who aren’t adept with smartphones. “We have a [smartphone] app,” Maltz said. “Zero people use it.”

Cities and States across the country are confronting the transportation needs of their aging populations, and many partnerships with startups--or more established companies like Uber or Lyft--are springing up.

“There are lots of models that have aspects of what is offered in SilverRide,” said Virginia Rize, co-director of the National Aging and Disability Transportation Center. “I think we’re in a period where there is tremendous development and enhancement of transportation options.”

The reason for this wave of developments nationally is a growing need that will be challenging to meet. The Americans with Disabilities Act requires local governments to provide rides for anyone who can’t use ordinary public transportation. Often, what’s provided are minibuses that carry multiple people, each to a different destination, while others ride along waiting for their stops. It can be a slow and inconvenient way to get around. In addition, these services are struggling to stretch their capacity for an aging population.

SilverRide hopes to expand into other markets to meet some of this growing demand.

[Founder Maltz] believes accessible transportation can translate into better health for aging people by enabling them to socialize and take part in activities they would otherwise miss. He gave an example by telling a story.

SilverRide got a call from someone whose uncle had been told he had two weeks to live, Maltz said. The uncle wanted to visit a gay bar one more time before he died. After making sure the man was OK to travel, SilverRide drove him to the bar and handed him off safely to the bartender.

“On the way back, the guy asked if we could take him again the next day. We told him we’d take him as many times as he wanted to go,” Maltz recalled. “The guy wound up going to gay bars three to five times a week — for the next five years.”