Four Houston companies showed the city what they're made of at TMCx's recent Demo Day. Courtesy of TMCx

Earlier this month, 16 medical device companies wrapped up their time at the Texas Medical Center's accelerator program and pitched their companies to fellow health professionals, guests, and more. While each made important connections in the local ecosystem during the program, a quarter of the entrepreneurs had roots in Houston already.

Four of the 16 TMCx09 companies that are headquartered in Houston. They have built solutions within sepsis, surgery, and transplant spaces in health care. Here's a little more about the homegrown companies that pitched at the event.

CorInnova

Photo via corinnova.com

The standard practice for acute heart failure patients is very invasive, says William Altman, CEO of CorInnova.

"The problem with existing devices is that they have invasive blood contact," Altman says. "Problem with that is blood contact is bad. It can cause up to 15 percent rate of stroke, which could kill you, and after five to seven days it provides 10 percent rate of blood destruction and has a 47 percent rate of kidney disfunction."

CorInnova's technology features a device that can be easily inserted through a 1-inch incision, and then be used for increase blood pumping by 50 percent.

"Surgeons tell us this is less invasive than minimally invasive aortic valve replacement, which is a widely done surgery, so this promises widespread adoption for our technology as we get it approved," Altman says.

The human prototype is expected to be ready in two years, with the next year being focused on animal studies. CorInnova is raising $12 million to accomplish its goals.

Ictero Medical

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An estimated 10 to 15 percent of the United States population will get a gallstone in their lifetime. Should one of those stones cause trouble or blockages, the only solution is to remove the gallbladder completely through surgery. However, Matthew Nojoomi, CEO and co-founder of Ictero Medical, has another idea.

Ictero Medical has created a minimally invasive treatment that uses cryoablation to defunctionize the gallbladder without having to remove it.

"The CholeSafe System not only treats the source of the disease, but it leverages existing clinical workflows that doctors use to access the gallbladder," says Nojoomi, adding that the process only uses mild station and pain control.

The company expects to get to humans in the next two years, and has launched a financing round.

PATH EX

path ex

Photo via tmc.com

Currently, sepsis is hard to identify in patience. Even if a patient is in a hospital, and that hospital knows the patient has sepsis, the individual still has a 38 percent chance of dying, says Sinead Miller, CEO of PATH EX.

"Right now the problems associated with sepsis are very clear," she says. "It's the leading cause of death in our ICUs, and it's also associated with the highest hospital cost and readmission rates."

PATH EX's technology allows medical professionals to better diagnose and treat sepsis. The PATH EX therapeutic device can be hooked up to a patient and flow his or her blood through the machine to capture bacteria, clean and recirculate the blood, and faster diagnose what sort of bacteria the patient has attracted. The device technology is similar to hemo hemodialysis, Miller explains.

The Houston company, which recently won big at the Ignite Healthcare Network's Fire Pitch Competition, was named an honoree within the Johnson and Johnson Breakthrough Medical Technologies Quickfire Challenge.

The company was recently received clearance from the Food and Drug Administration as a breakthrough device technology. PATH EX closed its $615,000 seed round — with plans for a series A next year — and has received $1 million in SBIR grant funding. The company was founded two years ago, and relocated to call Houston HQ this year.

Volumetric

Jordan Miller/Rice University

Volumetric is banking on their technology being among the inventions that will lead the medical industry into the future. The human tissue-printing technology company has created the 3D printer and the "ink" that can create whole organs for transplant.

"We can create complicated vascular architectures inside of soft water-based gels, in this case, mimicking the structure and function of human lung tissue," says Jordan Miller, CEO. "We can oxygenate red blood cells."

The company is commercializing its technology and has three streams of revenue, which as generated almost $1 million in revenue in Volumetric's second year. The company is also in the process of closing its seed round of fundraising.

Earlier this year, the startup, which works out of Rice University, was featured on the cover of Science magazine.

In 2020, the TMCx program will become a needs-based accelerator looking to solve problems the Texas Medical Center's member institutions face on a regular basis. Courtesy of TMC

TMC Innovation Institute announces redesign of its acceleration program for 2020

X-citing news

TMCx has been helping medical device and digital health startups create solid business plans and lasting relationships with Texas Medical Center institutions for five years, and on the accelerator's fifth anniversary, the team announced it's mixing things up a little to better accomplish those goals.

On Nov. 7, TMCx celebrated the conclusion of its ninth cohort, and 16 medical device companies pitched to a crowd at the TMC Innovation Institute. The companies in this cohort, just like the ones before it, were selected based on their technologies that solved a problem using digital health or medical devices. However, previously, the TMC's member institutions weren't directly part of the process until after the cohort was selected.

Based on feedback from alumni, member institutions, corporate partners, and stakeholders, TMCx has redesigned the program so that next year, the accelerator will focus on the specific needs of the needs that the organizations within the TMC have identified.

"Our focus going forward is on our member institutions — the clinics, the hospitals, and our partners who really bring forward these technologies into the future," says Emily Reiser, innovation strategist at the TMC Innovation Institute.

TMCx will become a needs-based accelerator program, Reiser says, and the team at the accelerator will partner with member institutions to run specific cohorts matched to their areas of interests.

The first step will be to identify these areas of interest, then in February of 2020, TMCx will invite a number of companies related to those interests to Houston for two weeks. The TMCx team, member institutions, and other stakeholders will get to interact with the companies and see how they stack up against each other, and to see if they can really fill the needs of the hospitals, clinics, and more.

Finally, after narrowing down the companies, the final startups and entrepreneurs will be invited to participate in a six-month accelerator program that will provide the same resources, connections, and programming that TMCx has always provided to advance the health startups.

Reiser says the TMCx team and all its partners will help identify the missing pieces these companies have and provide solutions, as well as making the right connections to all the right pilot partners, investors, clinical trial experts, and more.

"We'll be here to help them fill those gaps and make sure they have lasting relationships with our clinical partners in the hospitals," Reiser says.

At TMCx's Demo Day, the cohort's companies boasted of local deals and accomplishments. Courtesy of TMC

TMCx companies plant Houston roots with pilots, partnerships, and more

Lasting impact

At the conclusion of TMCx's recent Digital Health cohort — the most international group to date — there was only one Houston company among the 19. However, most of that group have developed a presence in Houston throughout the program.

Besides just being based here in Houston for four months, TMCx associate director, Lance Black, says the city has a lot to offer these startups.

"Why Houston? Why are these companies coming from everywhere to be here? Three big reasons," he says to the crowd at Demo Day. "The size and scale of the Texas Medical Center, the diversity of Houston, and the willingness and hunger of Houstonians wanting to be involved in innovation."

From pilots and partnerships to funding and mentorship, these TMCx08 companies announced the impact they've made on Houston at the Demo Day on Thursday, June 6. Meanwhile, TMCx had its own announcement that it would create early stage programming for professionals connected to the Texas Medical Center.

"It is the TMC's mission to advance health care, research, and education. It's our mission at the Innovation Institute to bring value back to the med center through health care technology," Black says. "And, through TMCx, we do that through startup companies."

Here are some examples of TMCx companies setting foundations in the Houston ecosystem.

Virti

Photo via virti.com

California-based Virti has developed an extended reality simulation technology for training medical staff. It's a cheaper, more effective way to train personnel, says Alex Young, CEO of the company.

Virti was selected to be in England's National Health Service accelerator — the only evidence-based AR/VR training company ever to be picked for the program, says Young.

With a presence in California and England, Young says he's also planted roots in Texas too, with sales representation based in the TMCx offices.

"In the time that we've been here, we've closed deals in Texas and back in California," Young adds.

Optellum

Photo via optellum.com

Optellum is changing the way lung cancer is being detected. With the startup's artificial intelligence-enabled detection software, oncologists can better identify at-risk patients, which translates into more treatment for those in need, and less for those who don't.

The company, which is based in the United Kingdom, has raised funds abroad while networking locally.

"TMCx has been amazing for a small British company like us. We have started pilots and trials at four TMC member institutions," says Vaclav Potesil, CEO.

Oncora Medical

Photo via oncoramedical.com

Angela Holmes, the director of product and customer solutions of Oncora Medical, sets the stage at her company's Demo Day pitch by telling a story of her friend's daughter who was diagnosed with cancer. She was forced to pick between two treatment options. She had no data or insights to help.

Oncora Medical's mission is to help fight cancer using data. Though based in Philadelphia, Oncora has Houston ties, since it formed a partnership with MD Anderson Cancer Center in April of 2017.

"We are so honored and gratified to be in a strategic, multi-year collaboration with MD Anderson to build this software system to save the world," Holmes says.

PreOp MD

Cody Duty/TMC

Within health care, the projected annual aggregate surgical expenditure by 2025 is expected to be $912 billion, says Christiana Obi, founder and CEO of PreOp MD, and a Houston-based anesthesiologist. She sees lack of information causing wasted surgical resources regularly.

PreOp MD — the only Houston-based TMCx company this cohort — has an app that allows for pre-procedure education, communication, and more that aims to prevent surgical delays.

While based here, PreOp is truly rooted in Houston, and even more so with their latest news.

"We are happy and excited to say that we have landed our first medical pilot at an medical right here in town," Obi says.

RoundTrip

Cody Duty/TMC

RoundTrip has a solution to 3.6 million missed or postponed medical visits that happen annually that are inconvenient to hospitals and a major health risk to the population: Ride sharing.

The Philadelphia-based company enables all forms of transportation and puts the power in the hands of the medical institution. From ambulances to other medical vehicles, the company can optimize utilization of all vehicles to get patients to their appointments and even has a partnership with Lyft.

While completing the TMCx program, RoundTrip closed its Series A round of $5.14 million led by Virginia-based Motley Fool Ventures in April. The funds will be used for expansion.

"Now we have all this new money to expand really rapidly. Texas, we're coming for you, whether you're ready or not," says Jackson Steeger, account supervisor.

Meru Health

Photos via meruhealth.com

Meru Health is also one of the 2019 TMCx Digital Health companies that has raised money while in the program. Palo Alto, California-based Meru completed a $4.2M raise in April 2019. The round was led by San Francisco-based Freestyle Capital.

Access to mental health professionals is increasingly more difficult, so Meru Health has created a low-cost digital clinic that offers an app-based treatment program from licensed therapists. Kristian Ranta, CEO and founder, while not yet providing specifics, that they aren't done in Texas.

"I'm happy to say there's some good stuff brewing here in Texas for us. More to follow," says Ranta.

Cloud 9

Photo via cloud9psych.com

Mental health is a key contributing factor in the legal system cycle, but it doesn't have to be Liz Truong, co-founder of Cloud 9. Better educating officers and providing them with mental health resources is the best way to get them out of the hospitals and court rooms and back out in the field to protect the city.

While some police departments have instituted ride-along programs with mental health professionals that have showed success, it's expensive for the police department and risky for those professionals. Cloud 9 has created a digital solution.

"We proved this works in the Harris County Sheriff's office right here in Houston," says Truong. "Officers reported that 97 percent of Cloud 9 care was superior or equal to their current program and showed an immediate 632 percent return on investment for our customers in the same budget cycle compared to what they were already spending."

Truong also says they have other local customers they are working with, including the Harris County Health Department.

Axem Neurotechnology

Photos via axemneuro.com

Recovering stroke patients need rehabilitation to get back to 100 percent, but getting patients into the facility is challenging and at-home compliance is hard to track.

Canadian company Axem Neurotechnology has a solution. With their external device and mobile application, physical therapists can track progress and communicate with patients remotely.

"When we talk to rehab professionals, they are excited about what we're doing," says Tony Ingram, CEO and co-founder. "That's why we have leading institutions in both Canada and the U.S. onboard for clinical trials — this includes TMC's own TIRR, which is consistently ranked in the top five rehab centers in the U.S. We're collecting core baseline data in the most diverse city in the country."


Correction: A previous version of this article said Oncora's partnership with MD Anderson was formed during the TMCx program, when the partnership began in 2017.

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Cancer-fighting company based in Houston emerges from stealth and snags $74M in its latest round

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A Houston-based clinical-stage biopharmaceutical company has raised millions in its latest round.

Tvardi Therapeutics Inc. closed its $74 million series B funding round led by new investors New York-based Slate Path Capital, Florida-based Palkon Capital, Denver-based ArrowMark Partners, and New York-based 683 Capital, with continued support and participation by existing investors, including Houston-based Sporos Bioventures.

"We are thrilled to move out of stealth mode and partner with this lineup of long-term institutional investors," says Imran Alibhai, CEO at Tvardi. "With this financing we are positioned to advance the clinical development of our small molecule inhibitors of STAT3 into mid-stage trials as well as grow our team."

Through Slate Path Capital's investment, Jamie McNab, partner at the firm, will join Tvardi's board of directors.

"Tvardi is the leader in the field of STAT3 biology and has compelling proof of concept clinical data," McNab says in the release. "I look forward to partnering with the management team to advance Tvardi's mission to develop a new class of breakthrough medicines for cancer, chronic inflammation, and fibrosis."

Tvardi's latest fundraise will go toward supporting the company's products in their mid-stage trials for cancer and fibrosis. According to the release, Tvardi's lead product, TTI-101, is being studied in a Phase 1 trial of patients with advanced solid tumors who have failed all lines of therapy. So far, the drug has been well-received and shown multiple durable radiographic objective responses in the cancer patients treated.

Dr. Keith Flaherty, who is a member of Tvardi's scientific advisory board and professor of medicine at Harvard Medical School, offered his support of the company.

"STAT3 is a compelling and validated target. Beyond its clinical activity, Tvardi's lead molecule, TTI-101, has demonstrated direct downregulation of STAT3 in patients," he says in the release. "As a physician, I am eager to see the potential of Tvardi's molecules in diseases of high unmet medical need where STAT3 is a key driver."

Networking with high-status colleagues isn't successful across industries, per Rice University research

houston voices

In a timeless scene from the mockumentary "This Is Spinal Tap," an 80s metal band swaggers in for a performance only to find they're billed second to a puppet show. Though the film is farce, real musicians often come to question the value of playing second fiddle to anyone – even an A-lister.

Now research by Rice Business professor Alessandro Piazza and colleagues Damon J. Phillips and Fabrizio Castellucci confirms those musicians are right to wonder. In fact, they discovered, the only thing worse than performing after a puppet may be opening up for an idol. Bands that consistently open up for groups with higher status, the researchers found, earn less money – and are more likely to break up than those that don't.

"Three cheers," The Economist wrote about the researchers, for confirming "what many people in the music industry have long suspected – that being the opening band for a big star is not a first class ticket to success."

While the findings may be intuitive for seasoned musicians, they fly in the face of existing business research. Most research about affiliations concludes that hobnobbing with high-status colleagues gives lowly newcomers a boost. Because affiliations give access to resources and information, the reasoning goes, it's linked with individual- and firm-level successes such as landing jobs and starting new ventures.

Both individuals and organizations, one influential study notes, benefit from the "sum of the resources, actual or virtual, that accrue to an individual or group by virtue of possessing a durable network of more or less institutionalized relationships."

That's largely because in many fields up and comers must fight to be taken seriously – or noticed at all. This problem is often called "the liability of newness:" In order to succeed, industry newcomers first need to be considered legitimate by the audience they're trying to woo.

Showing off shiny friends is a classic solution. In many fields, after all, linking oneself with a high-status partner is simply good branding: a shorthand signal to audiences or consumers that if a top dog has given their approval, the newcomer must surely have some of the same excellent qualities.

Unfortunately, this doesn't always hold true – especially in the creative world, Piazza's team found. In the frantic world of haute cuisine, for example, a faithful apprentice to a celebrity chef may actually suffer for all those burns and cuts in the star's hectic kitchen. Unless they can create meals that are not just spectacular, but show off a distinct style, consumers may sneer at the newcomer as a knockoff of the true master.

So what determines if reflected glory makes newcomers shine or merely eclipses them? It has to do with how much attention there is to go around, Piazza said. While partnering with a star helps in some fields, it can be a liability when success depends on interaction between audience and performer. That's because our attention – that is, ability to mentally focus on a specific subject – is finite. Consumers can only take in so much at a time.

Marketers are acutely aware of this scarcity. Much of their time, after all, is spent battling for consumer attention in an environment swamped by competitors. The more rivals for advertising attention, research shows, the less a consumer will recall of any one ad. In the world of finance, publicly traded companies also live and die on attention, in the form of analyst coverage of their stocks and angel investors' largesse.

Musicians who perform live, Piazza said, are battling for attention in a field that's gotten progressively more fierce, due to lower album sales and shorter career spans. Performing in the orbit of a major distraction such as Taylor Swift or Beyoncé, however, only reduces the attention the opening act gets, the researchers found. Though performances are just a few hours, the attention drain can do lasting harm both to revenue and career longevity.

To reach these conclusions, the researchers analyzed data about the live performances and careers of 1,385 new bands between 2000 and 2005. Supplementing this with biographical and genre information about each band along with musician interviews, the team then analyzed the concert revenue and artistic survival of each band.

They discovered that in live music, high status affiliation onstage clearly diluted audience attention to newcomers – translating into less revenue and lower chance of survival.

In part, the revenue loss also stems from the fact that even in big stadium performances, performing with superstars rarely enriches the underdogs. According to a 2014 Billboard magazine report, headliners in the U.S. typically absorb 30 to 40 percent of gross event revenues; intermediate acts garner 20 to 30 percent and opening acts for established artists bring as little as $15,000.

The findings were surprising, and perhaps dispiriting, enough for the researchers to carefully spell out their scope. Affiliation's positive effects, they said, are most often found in environments of collaboration and learning – for example academia. In these settings, a superstar not only can bestow a halo effect, but can share actual resources or information. In the music world, however, the fleeting nature of a shared performance makes it hard for a superstar band to share much with a lower-ranked band except, perhaps, some euphoric memories.

Interestingly, in many businesses it's easy for observers to quickly assume affiliations between disparate groups. In the investment banking industry, for instance, research shows that audiences infer status hierarchies among banks merely by reading "tombstone advertisements," the announcements of security offerings in major business publications. Readers assume underwriting banks to be affiliated with each other when they're listed as being part of the same syndicate – even if the banks actually have little to do with each other beyond pooling capital in the same deal.

In the music business, star affiliations mainly help an opening act a) if the audience understands there's an affiliation and b) if they believe the link is intentional. But that's not always the case because promoters and others in Big Music often line up opening bands. When possible, though, A-listers can do their opening acts a solid by making it clear that they've chosen them to perform there.

Otherwise, Piazza and his colleagues concluded, the light shed by musical supernovas typically gets lost in the darkened stadium. For the long term, business-minded bands may do best by working with peers in more modest venues – places where the attention they do get, like in Spinal Tap's classic metric, goes all the way up to 11.

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This article originally ran on Rice Business Wisdom and is based on research from Alessandro Piazza, an assistant professor of strategic management at Jones Graduate School of Business at Rice University.