Houston-based imaware, which has an at-home COVID-19 testing process, is working with Texas A&M University on researching how the virus affects the human body. Getty Images

An ongoing medical phenomenon is determining how COVID-19 affects people differently — especially in terms of severity. A new partnership between a Houston-based digital health platform and Texas A&M University is looking into differences in individual risk factors for the virus.

Imaware, which launched its at-home coronavirus testing kit in April, is using its data and information collected from the testing process for this new study on how the virus affects patients differently.

"As patient advocates, we want to aid in the search to understand more about why some patients are more vulnerable than others to the deadly complications of COVID-19," says Jani Tuomi, co-founder of imaware, in a press release. "Our current sample collection process is an efficient way to provide longitudinal prospectively driven data for research and to our knowledge, is the only such approach that is collecting, assessing, and biobanking specimens in real time."

Imaware uses a third-party lab to conduct the tests at patients' homes following the Center for Disease Control's guidelines and protocol. During the test, the medical professional takes additional swabs for the study. The test is then conducted by Austin-based Wheel, a telemedicine group.

Should the patient receive positive COVID-19 results, they are contacted by a representative of Wheel with further instructions. They are also called by a member of a team led by Dr. Rebecca Fischer, an infectious disease expert and epidemiologist and laboratory scientist at the Texas A&M University School of Public Health, to grant permission to be a part of the study.

Once a part of the study, the patient remains in contact with Fischer's team, which tracks the spread and conditions of the virus in the patient. One thing the researchers are looking for is the patients' responses to virus complications caused by an overabundance of cytokines, according to the press release. Cytokines are proteins in the body that fight viruses and infections, and, if not working properly, they can "trigger an over-exuberant inflammatory response" that can cause potentially deadly issues with lung and organ failure or worse, per the release.

"We believe strongly in supporting this research, as findings from the field can be implemented to improve clinical processes-- helping even more patients," says Wheel's executive medical director, Dr. Rafid Fadul.

Houston-based Imaware has launched at-home testing that can identify if the patient has — or even had — the coronavirus. Photo via imaware.health

Houston health tech startup launches game-changing, at-home coronavirus testing

be aware

Politicians, scientists, public health officials, and others continue to stress the need for widespread testing to tame the spread of the novel coronavirus.

Houston-based startup Imaware, an at-home health testing platform, recently rolled out an at-home coronavirus test for high-risk people, such as someone with both a fever and recent exposure to someone infected with the virus. Now, it's gearing up to offer an at-home test designed to spot the presence of coronavirus antibodies in your blood.

Experts view antibody testing as a key to corralling the virus and rebooting the virus-crushed U.S. economy. However, some skeptics fear the benefits of antibody testing are being oversold.

As explained by Health.com, a nasal swab test can detect a coronavirus infection. But a blood test can pinpoint whether a person has been exposed to the novel coronavirus, which causes the COVID-19 respiratory illness, and might now be immune to it.

Jani Tuomi, co-founder of Imaware, says his company is working with the U.S. Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) on approval of Imaware's antibody test. The in-home blood test might be available as early as May.

"We're still trying to make sure that everything checks out and validation is completed," Tuomi says, "but it looks like it's headed in the right direction."

In early April, the FDA approved the first test in the U.S. to detect coronavirus antibodies.

Tuomi says the process for Imaware's coronavirus antibody test will be similar to the one for the coronavirus detection test. Both tests, for instance, will be administered by licensed clinicians.

Here's how the basic test works.

To request a coronavirus test, someone completes a 10-question assessment at imaware.health. Austin-based startup Wheel, Imaware's telemedicine partner, created the online assessment.

Someone is given the go-ahead for testing if, as determined by a licensed health care professional, he or she falls into certain risk categories. For instance, somebody who's been exposed to a person with coronavirus and is over 60 years old would be approved for a test.

If health insurance covers the test or a patient pays for it entirely out of pocket, the test costs $135. (The home-based antibody test will cost about $120 to $125.) Public health agencies, including the Houston Health Department, can authorize a test for someone who can't afford it.

A trained health care professional goes to a patient's home to collect a test sample (by taking a nasal swab for the coronavirus test or drawing blood for the antibody test). A CDC-authorized lab then tests the sample. If needed, a board-certified health care professional can provide post-diagnosis care.

Results of a coronavirus test typically are available within three days. Tuomi says he hopes the results window for the test can be narrowed to between one and two days by the end of April.

"As a patient-advocate company, we are uniquely poised to be part of the testing shortage solution in Texas," Tuomi says in a March 23 release announcing the Imaware coronavirus swab test. "Our online platform, telemedicine partner, and in-home sample collection empower patients to take control of their health and access COVID-19 testing from the comfort of home."

Founded in 2018, Imaware employs 14 people. Others involved in the testing process, such as in-home testing clinicians and telemedicine experts, work for third-party partners. As the company adds to its testing lineup, Tuomi envisions the workforce rising to around 30 to 40 people by the end of 2020.

Earlier this year, Imaware (whose legal name is Microdrop LLC) had concentrated on home-based remote screening and monitoring for conditions like celiac disease and heart disease. But once it became clear that the coronavirus pandemic would be striking the U.S., the company shifted to coronavirus testing and, now, to antibody testing.

Before Imaware jumped into coronavirus testing, Tuomi performed a swab test on himself and realized that it wasn't feasible for anyone to do self-testing. On top of that, evidence surfaced that self-collection of test samples was producing a lot of false-negative results, he says. Subsequently, the federal government blocked self-testing for the coronavirus.

Today, health care professionals handle Imaware's at-home coronavirus testing and will handle the at-home antibody testing. The testing initially launched in Houston then expanded to the rest of Texas.

Tens of thousands of people have done coronavirus self-assessments through Imaware's online tool, Tuomi says. Far fewer people — in the hundreds — have actually fallen into high-risk categories based on the self-assessments and then have qualified for testing.

Tuomi says that as testing capabilities grow, Imaware will be able to accommodate people who fit into medium-risk coronavirus categories. Also, the company plans to offer its coronavirus test in states that neighbor Texas. Imaware hopes to provide its antibody test throughout the U.S.

In tandem with the public testing, Imaware teamed up with Austin-based energy tech startup RigUp to enable daily coronavirus screening at oil and gas jobsites. Imaware and RigUp are piloting the screening with several RigUp customers; they hope it eventually can be supplied nationwide.

"A cornerstone of the Imaware solution is the patient-centric approach offering superior telemedicine care from diagnosis to recovery," Tuomi says.

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Houston tech companies have raised over $466M so far this year, new report finds

money moves

This year might be a wash for a lot of things, but according to a new fundraising report from Houston Exponential, the Bayou City has seen an increase in funding this year compared to 2019.

The HTX Funding Review found that Houston startups raised $466.33 million across 46 deals between January and July — compared to $437 in the same time frame last year. While the increase seems marginal, it's important to consider the effect of the pandemic and the few months of troubles for the oil and gas industry.

The 7 percent increase in funding is impressive compared to the national average of 2.5 percent, according to the report, which was organized by Serafina Lalany, HX chief of staff. Eighteen later stage deals made up for 76 percent of the total money raised, indicating key growth for the ecosystem.

"This expansion in Houston's relatively new and booming tech innovation ecosystem shows a strength and resilience that is really exciting," says Harvin Moore, president of HX, in the report. "We are seeing a maturation of our very young ecosystem, as rapidly growing tech companies increasingly access later stage venture capital, which often comes from outside the local area."

The report calls out 11 deals — ranging from angel to late stage — that have occured in Houston to date in 2020:

  • Preventice Solutions, a medical device company, raised a $137 million series B led by Palo Alto-based Vivo Capital along with support from existing investors, including Merck Global Health Innovation Fund, Boston Scientific, and the Samsung Catalyst Fund.
  • Fintech and software-as-a-service company HighRadius raised a $125 million series B led by ICONIQ Capital, with participation from existing investors Susquehanna Growth Equity and Citi Ventures.
  • Liongard, a SaaS company, raised a $17 million series B led by TDF Ventures, Integr8d Capital, and private investors.
  • Base Hologram, a provider of hologram concert experience, raised $15.4 million in an outsized angel round this past May.
  • ThoughtTrace, another SaaS company, raised $10 million in a series B led by McRock Capital and existing investors, as well as Chevron Technology Ventures.
  • Renewable energy company Quidnet also raised a $10 million series B. Bill Gates-backed Breakthrough Energy Ventures and Canada-based Evok Innovations, which both previously invested in the company, contributed to the round.
  • SmartAC.com emerged from stealth mode with a $10 million series A fundraising announcement.
  • Retina AI, an AI company focused on diagnostics for diseases such as diabetic retinopathy from pictures of the retina, raised $4.1 million in an angel round which closed mid-July.
  • E-commerce platform Goodfair raised $3.67 million from but the round was led by Imaginary, with support from MaC Venture Capital, Global Founders Capital, Willow Ventures, Watertower, Amplify.LA, Capital Factory, and Texas Ventures.
  • SecurityGate, a cybersecurity platform, raised funds from Houston Ventures in June, but wouldn't disclose how much.
  • Oil and gas software company, M1neral, raised $1.6 million pre-seed co-led by Amnis Ventures and Pheasant Energy, among a few other select investors and strategic partners.

While the pandemic has made funding and vetting new portfolio companies, Blair Garrou, managing director of Houston-based Mercury Fund, says venture capital firms are committed to backing the strongest startups already in their portfolio.

"We've seen many VCs focus on a 'flight to quality,'" Garrou says. "Specifically, VCs are focused more on making sure their best performing portfolio companies have cash, especially at the later stages, as well as investing in the later rounds of new deals that are clear over-performers during COVID."

Looking forward, the HX report predicts that fundraising growth will continue throughout the rest of the year.

"There are several very large local deals in final term sheet stage, and we expect full year 2020 to be the highest ever for venture capital in Houston; our ecosystem is really thriving," says Moore in the report.

Houston investor: Is this the golden age for B2B software?

Guest column

B2B software as a service, or SaaS, founders entered 2020 riding a wave of the longest economic expansion in United States history. Valuations increased to new highs, funding rounds continued getting larger at each stage, and forecasts went up and to the right fast. But then, March hit.

Quickly and seemingly out of nowhere, headlines became dominated by apocalyptic predictions of death, record levels of unemployment, shocking economic forecasts of GDP contraction, historic mass layoffs and furloughs, and unprecedented multi-trillion dollar economic stimulus packages. For founders every instinct began screaming to cut costs and hunker down.

But should B2B SaaS founders cut their organizations right now? Through analyzing a few key events and looking to the evidence in the market today, founders can develop a strategy for growing during this crisis. Not only is growth cheaper for most B2B SaaS against the backdrop of economic meltdown, but with the majority following a hunker-down instinct, a growing B2B SaaS firm will compare very favorably against a landscape of stale and stagnant competitors.

Reviewing the 1918 Spanish Flu Pandemic and the 2008 downturn

While the health implications vary widely between the current pandemic and the 1918 flu epidemic, the economic reactions share many similarities. The US response to 1918 was just as fractured as the states' reactions to COVID have been this year. As cities and states in 1918 shut down commerce to stem the spread of the flu, economic contraction quickly gave way to rebound, the so called "V-shaped recovery," despite the Spanish Flu having much higher death rates among working individuals than COVID-19.

There are major differences between 1918 and 2020, however. First, there is untapped potential in technology to replace workers. As businesses look for ways to cut costs, expect them to aggressively turn to automation, ultimately depressing real wages. Second, the 1918 response did not include shutdown measures as draconian as those we are experiencing in 2020. This could lead to permanent output loss across a wide range of industries, increasing real prices just as real wages decline. And third, the trillions of dollars in federal economic relief are unlike anything attempted in 1918.

The 2008 downturn that nearly brought the financial sector to a halt rippled through the economy as businesses in a wide range of industries made steep cuts to operations and capital expenditures. Despite this dangerous environment, SaaS firms increased profitability and continued to grow revenues each quarter. Growth slowed but remained positive while most other companies experienced absolute declines in revenue.

Customer acquisition for SaaS businesses usually gets more efficient during downturns, driving the potential for faster growth. The performance of all publicly traded B2B SaaS firms during 2008 illustrated in Figure 1 above proves the resilience of this category during a recession. While revenue continued to grow, profitability rose from a 10 percent loss on average to a 5 percent gain on average by 2010. This is likely due to firms freezing salaries and hiring and perhaps cutting down the sales and marketing budgets.

Downturn case study: Salesforce

Salesforce entered the downturn as a category leader in B2B SaaS with nearly $500M in revenue in 2007 and $3.5 million in operating losses. Throughout 2008, the company grew revenues by 51 percent to $748 million and operating profit surged to $20.3 million. And in 2009, the company repeated this stellar performance by growing revenues 44 percent to $1,077M and operating profit to $63 million. These results occurred against the backdrop of a global financial downturn and with a product focused on helping people sell more effectively (not something one would expect would sell well during a free-fall recession).

The revenue growth throughout those years followed the growth in sales and marketing spend. In 2008, the company grew sales and marketing by 49 percent, driving 51 percent revenue growth at about $1.50 of sales expense per $1 of recognized revenue added. In 2009, the company grew sales and marketing 42 percent resulting in 44 percent revenue growth at $1.63 of sales expense per $1 of recognized revenue. By 2010, the sales growth advantage was gone and Salesforce not only dropped its expense growth rate but also reverted to spending $2.64 per $1 of new revenue added.


Looking at these results Salesforce executed on the growth opportunities in 2008 and 2009 by ramping up sales expenses. The relative cost to acquire customers in 2008 and 2009 compared to 2010 proved significantly cheaper (approximately 40 percent less expensive). When faced with an advantage like that, every founder should charge ahead.

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Andrew Smith is vice president of Houston-based Golden Section Venture Capital.

Dive deep into Deloitte's artificial intelligence findings

Real Intelligence

As AI adoption grows, how are companies working to manage risk and stay ahead of the pack? Deloitte's third annual survey suggests how leaders' thinking is changing as applications become pervasive throughout the organization.

For the third straight year, Deloitte surveyed executives about their companies' sentiments and practices regarding AI technologies.

Of particular interest is understanding what it will take to stay ahead of the pack as AI adoption grows, and how adopters are managing risk around the technologies as AI governance, trust, and ethics become more of a boardroom issue.

Continue reading this article on Deloitte's website to explore the global key insights such as why the early adopter phase is ending and what it might take to stand out when AI becomes ubiquitous.

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This publication contains general information only and Deloitte is not, by means of this publication, rendering accounting, business, financial, investment, legal, tax, or other professional advice or services. This publication is not a substitute for such professional advice or services, nor should it be used as a basis for any decision or action that may affect your business. Before making any decision or taking any action that may affect your business, you should consult a qualified professional advisor. Deloitte shall not be responsible for any loss sustained by any person who relies on this publication.

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