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Primum non nocere — Latin for “first, do no harm” has been enshrined by the medical practice since the times of the Hippocratic Oath. Unfortunately erring is part of the human condition and despite all the checks and balances, medicine does have a fair share of it. In fact for many years now medical errors are reported as the third leading cause of deaths in the US, the graph below being a Johns Hopkins study from 2016.

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To put this in perspective consider that medical errors are far more prevalent than other types of accidental deaths:

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And the number of malpractice claims that are getting paid has actually been declining in recent years, per the figure below from author David Belk, MD:

blankPatients don’t help their case either, with medication non-compliance being the hallmark of 50% of cases costing an estimated $300B / year i.e., almost 10% of annual healthcare costs. A 2017 CDC study shows the many reasons for non-compliance:

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So how have entrepreneurs been addressing these issues? Medical errors overall is obviously such a large topic, much beyond the scope of a short article, but if think of it in three main buckets focusing on a case study each, we can illustrate the opportunities.

1) CommunicationRubiconMD helps primary care physicians gather first opinions from specialists before making an actual referral. The company has shown savings in time and money and increased patient satisfaction. The ultimate consequence is arguably improved outcomes, after all in the US miscommunication is a great cause in us undertreating when needed and overtreating when not needed. Key here is that the opinion is crowdsourced — wisdom of the crowds at its finest.

2) FatigueRecoverX auto-generates diagnostic insights from audio (patient voice) and text / images (patient’s EHR) to help doctors separate real issues from red herrings. Consider how medical professionals live in fear in the US because of our culture of litigation, how there is increasingly more data to be analyzed, and how increasingly less time is spent on patients themselves, and one can appreciate the value RecoverX brings. Key here is that the product is integrated in the workflow — a solution for fatigue shouldn’t cause fatigue in of itself.

3) Technical FailuresFerrum Health uses AI to monitor for critical care gaps across the oncology, vascular, and trauma patient journeys. By running algorithms in the background on the diagnostic imaging and unstructured radiologist reports performed across a health system, it detects studies where an error might have happened. The flagged studies are reviewed by the quality committee, assuring a second opinion when errors occur. As many others have written, we are very far from general-purpose artificial intelligence, not to mention our societal regulations and human expectations. Key here is the AI is not the final arbiter of truth — it’s a tool that improves physician performance.

At Tau Ventures we believe some measure of error is unavoidable but are encouraged to see startups making a real dent. Our view is the challenge is fragmented and huge enough that many specialized solutions are needed and that there is space for multiple winners.


I am a minor investor in RubiconMD; thanks to Gil Addo, Jennifer May Lee and Pelu Tran for their feedback. Originally published on “Data Driven Investor,” am happy to syndicate on other platforms. I am the Managing Partner and Cofounder of Tau Ventures with 20 years in Silicon Valley across corporates, own startup, and VC funds. These are purposely short articles focused on practical insights (I call it gl;dr — good length; did read). Many of my writings are at https://www.linkedin.com/in/amgarg/detail/recent-activity/posts and I would be stoked if they get people interested enough in a topic to explore in further depth. If this article had useful insights for you comment away and/or give a like on the article and on the Tau Ventures’ LinkedIn page, with due thanks for supporting our work. All opinions expressed here are my own.

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Amit Garg
I have been in Silicon Valley for 20 years -- at Samsung NEXT Ventures, running my own startup (as of May 2019 a series D that has raised $120M and valued at $450M), at Norwest Ventures, and doing product and analytics at Google. My academic training is BS in computer science and MS in biomedical informatics, both from Stanford, and MBA from Harvard. I speak natively 3 languages, live carbon-neutral, am a 70.3 Ironman finisher, and have built a hospital in rural India serving 100,000 people.

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