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File: Bear Cieri
From left: John Evans, Peter Roy, Christian Cobaugh, Elias Joslin, Lynda Menard and Hana Kibe-Chartie

Vermont earned a pushpin on the global health technology industry map decades ago when homegrown entrepreneurs founded BioTek Instruments, the Winooski life science instruments company now known as Agilent, and IDX Systems, the South Burlington health information technology firm. While those businesses have since been sold to bigger, out-of-state companies, Vermont has been incubating a new generation of cutting-edge health tech enterprises.

Investors have poured millions of dollars into these companies in hopes of getting in on the ground floor of the next game-changing software, medical device or biological product. A new venture fund, Features Capital, has even popped up to invest in health tech startups.

People with ties to IDX and BioTek continue to serve as investors and mentors for the new wave of companies. The region’s two major academic medical centers — the University of Vermont Medical Center and Dartmouth-Hitchcock Medical Center — are helping staff spin ideas into commercial ventures. Established entrepreneurs still choose to launch companies in Vermont because of the lifestyle it offers. And the state’s one degree of separation continues to breed collaborations.

Combine all this with a global demand for health technology that’s only grown during the pandemic, and you’ve got a prescription for success.

Since it can be hard to know whom to pay attention to in a world as fast-evolving as tech, Seven Days spoke to the leaders of five Vermont companies in various stages of growth. (Read about a sixth company, CoreMap, and its cofounder and CEO, Sarah Kalil, here).

These companies, whose products range from artificial intelligence programs that can predict deadly diseases to a device that can offer a more humane way to keep intubated patients safe, represent the vast diversity of the state’s tech industry — and its potential to help shape health care’s future.

Vernal Biosciences

When Seven Days visited Vernal Biosciences last summer, the months-old company was just adjusting to life as a startup. Its eight full-time employees were crammed into its Colchester lab space, while expensive equipment sat bubble-wrapped on pallets waiting to be set up.

A year later, much has changed.

The company — which manufactures messenger ribonucleic acid, or mRNA, the genetic script that carries instructions to the protein-producing machinery of cells — raked in $21 million in investment funds this summer, allowing it to go on a hiring spree that shows no signs of slowing down. Forty people now work at Vernal, while the company’s website has nearly a dozen job postings; it plans to move into a bigger space in the near future.

The boom is a testament to the ever-expanding market for high-purity mRNA, which, in an industry filled with promises of the next hot thing, may very well be the hottest. A main ingredient of COVID-19 vaccines, mRNA has also been used to create some cancer treatments and is being tested in what would be the first-ever HIV vaccine.

While large pharmaceutical companies manufacture mRNA to use themselves, small and midsize biotech drug researchers are now clamoring for the type of mRNA that Vernal specializes in making.

Vernal’s founder, Christian Cobaugh, has a PhD in cell and molecular biology and a long history in life sciences manufacturing, including years spent working for companies based in the Boston-area health tech hub. He was overseeing mRNA manufacturing for a company there when, in 2020, he and his family spent a month in Vermont on a whim. A month turned into two until, eventually, Cobaugh decided to relocate to Stowe permanently — and launch his own company in the process.

Among his motivations, Cobaugh said, was the work-life balance Vermont offers. That doesn’t mean he’s working less than he was before; on the contrary, life as the CEO of a tech startup can be hectic even on the best days.

“But if you have to work on a Saturday or an evening, it’s not too hard to mix in a killer hike, a bike ride or a tour around the neighborhood on skis,” he said.

PanicMechanic

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Luke Awtrty
Ellen and Ryan McGinnis of PanicMechanic

Smartphones and anxiety usually go together like hot dogs and heart disease, but there are some exceptions.

PanicMechanic is one of them. The app, created by UVM professors Ryan and Ellen McGinnis, is meant for people who suffer from regular panic attacks — a group that includes many of the more than 40 million Americans with diagnosed anxiety disorders.

The app is built around the concept of biofeedback, a promising treatment method that involves charting the physiological changes brought on by panic attacks while they’re happening.

Users put their finger over their smartphone camera with the light on, and the app records a video that tracks and displays their heart rate in real time. The app also asks people to rate the severity of the attack and document what might have led to it, from changes in sleep patterns and exercise to diet and alcohol consumption. This helps users understand their triggers and provides something to focus on during the attack.

“Our studies suggest the process of doing that helps you confront this feeling of being out of control and break the positive feedback loop of panic,” Ryan McGinnis said.

The spark for PanicMechanic has personal roots: Ellen McGinnis used to suffer from panic attacks herself. In grad school, she would often experience debilitating episodes twice a week. Then, in 2012, during the second year of her PhD program, she learned about biofeedback. She began charting her pulse rate whenever a panic attack began. After three weeks, the attacks stopped — for good.

The McGinnises, who live in Shelburne, launched the app in April 2020 with the help of the college’s tech transfer program, UVM Innovations, which provides guidance and technical assistance to researchers who want to take their ideas commercial. A “rotating cast” of students, faculty collaborators and outside consultants also helped out, they said.

With full-time jobs and two kids, the couple haven’t had much time to market PanicMechanic to a broader audience, something they hope to soon change. Even so, the free app has been downloaded between 5,000 and 10,000 times, according to Ryan McGinnis, confirming the need.

“They just searched for something until they found us,” he said of the app’s users.

Biocogniv

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Luke Awtry
From left: Jabez Boyd, Artur Adib and Kylin Willis of Biocogniv

Artificial intelligence is used to guess your streaming preferences, teach students algebra, and even get ahead of deadly storms and wildfires. Why not use it to predict when people might get sick?

One Vermont company is trying to do just that — and hopes to eventually help prevent one of the leading causes of hospital deaths in the U.S.

Biocogniv, a Burlington company, has created an AI program that can sift through basic hospital blood tests to predict the likelihood that patients will come down with certain illnesses within hours of arriving at the emergency department, much faster than the current standard of care. The firm is working on a handful of detection tools, including one that can predict when people might develop sepsis, a life-threatening immune response to infection that kills more than 250,000 adults in the U.S. each year.

“We’re doing so with a high level of accuracy — and earlier than most similar products in the market can,” said Jabez Boyd, Biocogniv’s chief operating officer.

Biocogniv was founded in 2019 by Artur Adib, a former Twitter engineer and faculty member at the National Institutes of Health who lives in South Burlington. His new company announced a $6 million round of investments earlier this year, including from Boston Scientific cofounder John Abele of Shelburne and IBM’s former CEO, Sam Palmisano.

While the company’s detection tools are still in the testing phases, it has already made a difference.

This summer, the University of Texas Medical Branch in Galveston released the findings of a 13-month pilot in which it used Biocogniv’s “laboratory intelligence platform,” known as clinOS, to help process more than 325,000 COVID-19 tests. Using PCR and antibody testing, patient vitals, and medical history, the program helped make personalized treatment recommendations that resulted in lower rates of intensive care treatment, reduced mortality rates and a near doubling of efficiency, the hospital reported.

The Galveston medical center has since expanded the use of Biocogniv’s platform and, in a recent press release, said it continues to be impressed with the results.

Voi

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Courtesy
Rick Johnson of Voi

One of Rick Johnson’s responsibilities as chief of staff of the Marine Corps Reserve was to investigate the suicides of Marines and sailors. He would talk to their friends and families to see what, if anything, could have been done to prevent their deaths.

“It was devastating,” he said, recalling many such conversations.

He vowed to do what he could to reduce suicides upon his retirement. While working at Dartmouth College in 2012, he met professor Bill Hudenko, a renowned mental health expert. Five years later, the pair launched Voi, a technology company based in Springfield that’s trying to better identify and support people at risk of suicide. (Hudenko, who served as the company’s first CEO, has since stepped down but remains a board member, Johnson said).

The company has two flagship products, starting with Voi Detect, an app that uses an algorithm-based questionnaire developed by a team of UVM researchers to quickly screen people for suicide risk.

The app first poses some basic questions, such as “How are you coping” and “How upset are you?” Based on the responses, it then decides whether to advance users to a second set of more probing inquiries: about their will to live and whether they’ve recently considered suicide. A confidential assessment score visible only to the person who is administering the questionnaire then indicates whether someone is at high risk of harming themselves within the next 72 hours.

The app is designed to replicate the expert judgment of a psychiatrist, requires no specialized training, takes only two minutes and can be administered on a tablet — making it ideal for screening a lot of people in a short amount of time.

“You can do universal screening and then focus your very expensive, very scarce resources on those people who [most] need the help,” Johnson said.

Dozens of hospitals contract with Voi to use the app, as does the Virginia prison system. Johnson is also in discussion with National Guard units and said he hopes eventually to market it to college and university health services.

The company’s second product, Voi Reach, is a mobile messaging app for people struggling with suicidal ideas and other mental health issues. Users will be connected to a remote coach who will help them identify three people in their lives who can support them. The coach can then communicate directly with the person’s support team and offer guidance and resources, including interactive modules, on how to best help the person.

Johnson, who lives in Hanover, N.H., is currently Voi’s only full-time employee but said he is trying to raise $3 million in capital so that he can hire some people to help him keep pace with a growing demand for the company’s products.

He’s preparing to sign contracts with the Arizona, Rhode Island and Pennsylvania National Guards to outfit them with the Voi Detect app and said he’s talking with a number of groups working to reduce suicides among veterans and Native Americans.

He suspects the stress of the pandemic, coupled with the 8-month-old war in Ukraine, has contributed to the growing interest in Voi’s products. But as staffing shortages continue to plague many sectors, large organizations are also looking for ways to stretch their existing mental health resources, he said.

Johnson hopes eventually to begin actively marketing his apps, instead of just scrambling to respond to the unsolicited emails he has been receiving. For now, though, word of mouth seems to be doing the trick: The Arizona National Guard, for instance, contacted Johnson after hearing about Voi Detect from its counterpart in Vermont.

That tells Johnson the products have started to make a difference. “They’re hearing the success stories,” he said.

Healthy Design

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Jon Olender
Dr. Marie Pavini showing off Healthy Design’s Exersides Refraint System

Intubated hospital patients will sometimes be tied to their beds to prevent them from ripping out their breathing tubes when they regain consciousness. Some become so agitated by the restraints that they need to be sedated, which can cause its own problems, from delirium to healing delays.

Dr. Marie Pavini, a critical care specialist, always hated watching this unfold during her shifts in the Rutland Regional Medical Center intensive care unit: “Every time I would walk out of a [restrained] patient’s room, I would have this awful, guilty feeling,” she said.

So she did something about it. After work one day in 2015, she went to Home Depot, bought some metal and plastic and started constructing what would later become the flagship product of her budding technology company, Healthy Design.

Known as the Exersides Refraint System, the device makes it nearly impossible for ventilated patients to dislodge any tubes, whether on purpose or by accident, while still allowing them to safely move their arms.

It achieves this by placing their hands in a pair of clear tubes that are connected to a plastic rod that runs the length of their arms and allows some range of motion.

While the device still provides a way to fully restrain agitated patients when necessary, most don’t need it, Pavini said. The freedom to move their arms is often enough to keep them calm.

Pavini refined the device over several years based on feedback from doctors, nurses and patients. A mix of research funding and grants, meanwhile — including one from NIH meant to help companies bring promising products to market — allowed her to hire nearly a dozen employees who now work out of the old Rutland Herald building.

Pavini, who founded Healthy Design in 2016, left her hospital job last year to focus on the company full time. She’s waiting to receive what she expects will be promising clinical data from a three-year trial performed at the UVM Medical Center, Johns Hopkins Hospital in Maryland and the University of California, San Diego Medical Center. She can already sell the device commercially but said she hopes the trial data will help her market the product.

In the meantime, she’s bouncing around the U.S. on a tour to pitch her device to a broader audience. She will attend two conferences in Texas and a third in Washington, D.C., this week alone.

It’s a hectic schedule, but one that she’s glad to have, she said, knowing that she could one day help change the way ventilated patients are treated in hospitals nationwide. “If I could leave that as a legacy, I’ll have done my job,” she said.