Dr. Eric Topol to shiny new venture-backed Silicon Valley startup: Prove it

A new startup with an impressive list of investors has run a coordinated PR campaign to publicize its high-tech reimagining of the primary care. A prominent digital health proponent and cardiologists needs some answers.

Stack of coins, increased under a magnifying glass

“All that glitters is not gold.”

In the Merchant of Venice, Shakespeare crafted this phrase for the heroine Portia to help her make a wise choice in picking a husband. The proverb is particularly apt today as technology makes inroads in healthcare promising to make better all that ails this tired, old, fearful-of-change industry.

Take the newest tech kid to jump on the extreme healthcare makeover bandwagon: Forward, which has Dr. Eric Topol, cardiologist author of The Creative Destruction of Medicine scratching his head.

The  San Francisco startup, which launched Jan. 17 to reimagine primary care, has a veritable who’s who of investors: Khosla Ventures, Founders Fund, John Doerr, and First Round Capital as well as angel investors including Eric Schmidt, Marc Benioff, Garrett Camp, SV Angel, Aaron Levie, Joe Lonsdale.


A doctor using a sleek display at Forward to interact with patients.

Forward is led by Adrian Aoun, CEO and founder, who sold Wavii to Google and led special projects at Alphabet (formerly Google). Already a ton of cyberspace has been devoted to Forward and its first clinic in San Francisco, which recalls the sleek lines of an Apple store fitted with body scanners, sensors, sleek interfaces and a futuristic feel. For $149 per month, people can visit the Forward clinic as many times they want, no insurance or copays needed.

Not surprisingly, the media coverage of the vision, the high-tech glitz, and glam behind Forward has caught the eye of Dr. Topol widely known to embrace technology-driven transformation of medicine. In fact, he believes that the future of medicine is digital.

“I have seen no less than 10 articles from different media in the last few days and so clearly their launch was a major blitz with PR muscle and expenses,” Topol said, in a phone interview Friday. “In the Bloomberg video, there is a woman who is standing on something that looks like a scale and [it] has all kinds of metrics and I am thinking, “What is this? I have never seen this before and I am up on technology.'”


Body scanner designed by Forward

That scale (seen left) is actually a body scanner that Bloomberg Reporter Ellen Huet stood on when she reported on the company. Per Forward’s media kit, it “uses an array of sensors to understand each member’s body and measure heart health.”

Later in the video, Huet’s veins light up under a vein finder and her genomics panel results showing that they are negative for cancer are featured on a cool-looking interface. Topol was especially struck by a phrase Huet uses in the video – ‘orgy of high-tech dazzle” and the lack of any information on the Forward website because it raised a fundamental question in his mind.

“I would be firstly interested in what new tools they are using because are they proven, are they validated, are they well-accepted, and moreover I am particularly interested in publishing results to show that this gadgetry is helping these people,” he said. ” The one thing they showed in the video of using something to find the veins, you don’t need that in 95 to 99 percent of the time. So some of that [technology] is gimmicky.”

Here’s what Forward offered up in an email sent by a woman at a PR firm representing the company. She declined to name anyone to whom the information could be attributed to:

MedCity: Do you have any data to validate the results of the various tests that you run?

Forward: We don’t disclose member test results, but every device, lab machine, and sensor we use is FDA-approved.

MedCity: Whose test do you use on the cancer panel that was run on the Bloomberg reporter? I am assuming it is not an in-house test.

Forward: We do next-generation sequencing looking at 30 oncogenes.

MedCity: Who makes the various sensors and devices that are used to reimagine the primary care clinic?

Forward: Some examples include:

  • Sleep sensor that tracks not only your sleep but also the environment in which you sleep (e.g., particulate count, light levels, ambient noise, etc.)
  •  FDA-approved retinal imaging sensor (aka digital ophthalmoscope) that allows us to remotely monitor your eye health in cases of glaucoma, diabetic retinopathy, etc.
  • FDA-approved glucometer for diabetics
  • FDA-approved blood pressure cuff in case we’re concerned about low or high blood pressure

The media kit, which includes a fact sheet, points out that members who shell out $149 per month or those who qualify to receive the membership to Forward for free receive a variety of sensors that can be used at home. All data is collected and gathered through a mobile app. The fact sheet said that Forward’s doctors come from Bay Area institutions like Stanford, Sutter Health and Kaiser Permanente.

But the PR person wouldn’t name the companies that make the devices being used and the cancer panel. Nor would she disclose how much money Forward has raised from investors.

The lack of transparency is troubling.

“If you want to do something that is new and claim that it is disruptive, then you better be publishing results of how you’re hopefully helping people and not harming them,” Topol said in the phone interview. “You mention Theranos and I met Elizabeth Holmes I was very impressed. I had my blood work done and I got my results in minutes. I said, ‘Well, this could be very disruptive.’ But I pleaded with her to do head-to-head studies. Compare it with Quest and LabCorp and conventional lab testing to prove that the results were similar and that you can do this with a droplet of blood. And that was never done.”

Topol said he agrees with Vinod Khosla — the investor who often turns heads with his healthcare pronouncements and who mentioned Forward during JP Morgan week a week before it launched — that true disruption most often is external.

But ignore the value of Q.E.D. at your own peril.

“Disruption is most likely to come from the outside because medicine is so terribly entrenched, but when you disrupt from the outside, there are still certain core practices and accepted standards that you can’t sidestep,” Topol warned. “If you want to be an outsider and be a disruptor of healthcare you are still held accountable to the same standards of ‘You got to prove it.’ One of the things is that if you have technology that’s not proven, everyone assumes that it’s harmless but it could actually be harmful when you get incidental findings or if you come up things that are not true.”

The PR campaign has been successful. Almost every article mentions the Apple look and feel of the Forward clinic. Primary care also needs a makeover, so the vision is spot on. Now comes the hard part of validation and data publication to boldly take patients where they’ve never gone before.

Photo: AlisLuch, Getty Images and Forward