Babylon Health

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Babylon Health

Traded as	NYSE: BBLN
Industry	Health care
Founded	2013 (2013)
Founder	Ali Parsa
Defunct	2023 (2023)
Fate	Bankruptcy and sale
Headquarters	London, United Kingdom
Revenue	US$322.9 million[1] (2021)
Number of employees	2,189[2] (2021)
Website	babylonhealth.com

Babylon Health was a digital-first health service provider that combined an artificial intelligence-powered platform with virtual clinical operations for patients. Patients are connected with health care professionals through their web and ^[3]mobile application.^[4]

The company's subscription business model for private healthcare services was launched in the UK in 2013, and later expanded internationally to 17 countries including Cambodia, Hong Kong, India, Indonesia, Laos, Malaysia, the Philippines, Rwanda, Singapore, Taiwan, Thailand, the United States, and Vietnam.^[5][6] In 2019 the company covered over 20 million people and provided over 5,000 consultations per day.^[7]

The American branch filed for bankruptcy in August 2023 and the British branch called in the administrator weeks later.^[8] In August 2023, Forbes reported Babylon was "winding down" its business in Rwanda, potentially disrupting care for 2.8 million people.^[9]

In August 2023, Babylon Health's UK operations were bought by eMed Healthcare UK, limited.^[10] This allowed its private and "GP at Hand" NHS business to continue operating under the new brand name "eMed".

The company was founded in 2013 by Ali Parsa, who was previously the CEO of the Circle Health hospital operator and investment banker. Babylon Health, formerly Babylon Health Services Ltd, is owned by its holding company Babylon Holdings Limited^[11] along with Babylon's technology branch, Babylon Partners Limited.^[12] In 2014 Babylon Health Services Ltd. became the first service of its kind to be registered with the Care Quality Commission, the health care services regulator and inspector in England.^[13]

In January 2016, Babylon received financing of US$25 million, the highest financing for a digital healthcare company in Europe. Investors include Hoxton Ventures, Kinnevik and the founders of Google Deepmind.^[14] In August 2019, $550 million was brought in with a new financing round to further develop the skills of the artificial intelligence of the Babylon software. The equity items correspond to an assessment of the value of company of over $2 billion. According to the company, around 4,000 daily medical consultations were offered in 2019.^[15]

Babylon Health provides health care services through either its website or iOS and Android mobile applications. This is funded through a subscription-based model, pay-as-you-go payments, centrally funded initiatives like NHS or as part of health insurance packages.

Users can send questions or photos to the company's team of health care professionals (which includes doctors, nurses, and therapists) in a manner similar to a text message.^[13] Alternatively, users can hold video messaging consultations with a clinician to answer questions about common medical topics such as fever, sore throat, allergies, skin irritations, and colds. This service also allows users to receive referrals to health specialists, have drug prescriptions mailed to the user or sent to a pharmacy or to consult with therapists to discuss topics such as depression and anxiety. In situations where a physical examination is required users can book health exams with a limited number of facilities in London, and nurse appointments are limited to one location.^[16]

In addition to the direct healthcare services, users can access various health monitoring tools such as an activity tracker, order home blood-test kits^[17] and review general lifestyle and fitness questions.

In September 2018, Babylon formed a partnership with the Canadian digital solutions company Telus Health to deliver Healthcare services in Canada. In 2021, Babylon stopped providing clinical healthcare services in Canada and entered into a software licensing deal with Telus.^[18]

In September 2016, Babylon Health launched in Rwanda as Babyl, in partnership with the Bill and Melinda Gates Foundation. Rwanda was the first country outside of the UK to acquire Babylon Health's services. By May 2018, Babyl was reported to have 2 million members, covering roughly 30% of Rwanda's adult population.^[19]

In 2018 Babylon launched their artificially intelligent chatbot in Rwanda.^[20] At the time of launch, the Babylon AI system did not include some common diseases relevant to Rwanda such as tuberculosis or Malaria.^[21]

In January 2020, Babylon Health reported 1 million completed consultations in Rwanda. In March 2020, the company signed a 10-year partnership with the Rwandan government, agreeing to roll out Babyl to all Rwandans over the age of 12 through the government's community-based health insurance scheme, Mutuelle de Santé.^{[citation needed]}

In the UK, Babylon Healthcare Services Ltd provides services via private subscription, pay-as-you-go and through the private medical insurer Bupa from 2013.

In November 2017, Babylon additionally launched GP at Hand, providing a free at-the-point-of-care, NHS-funded service.^[22] GP at Hand NHS patients can book virtual appointments through the Babylon App and if necessary request in-person appointments at one of Babylon Health's clinics. NHS GPs can prescribe medication, issue sick notes, and refer users to specialists.^[23] In August 2021 Babylon GP at Hand had a list of over 100,000 patients. The patient population is significantly skewed towards younger patients, with 85% of GP at Hand patients being aged between 20 and 39, compared with just 28% nationally.^[24] The service was criticised for explicitly discouraging registration of older, frailer, demented, pregnant patients, those needing end-of-life care, and those with complex social, physical and psychological needs, thereby creaming off the more lucrative younger and healthier patients, leaving other NHS practices to handle the others.^[25]

In August 2022 Babylon Health announced cuts to its NHS GP at Hand service in Birmingham as it was not profitable. Babylon also ended a ten-year partnership with the Royal Wolverhampton NHS Trust after only two years as it was not making enough revenue.^[26]

Also in August 2022, shortly after the opening of large-scale office space in Euston to accommodate clinical staff, founder Ali Parsa addressed the entire company in a video conference and announced widespread immediate company cutbacks whereby nearly half the workforce was made redundant from the company's Knightsbridge and Euston offices, including many head office staff who had been working at Babylon since its inception, and many other clinical operations staff members. This unexpected zero-notice action left many staff with subpar redundancy packages.^[27]

Parsa was replaced as director by Miami-based Michael Cole.^[25] The company collapsed into administration on 11 September 2023 and its assets were sold for £500,000 to US giant EMED Healthcare, which promised continuity and expansion.^[8][25]

Babylon began operations in North America in 2018. In August 2019, at the same time as their series C funding announcement, Babylon Health stated that the new investment would, amongst other uses, allow for international expansion into the United States.^[28]

In May 2020, Babylon Health announced a partnership with Mount Sinai Health Partners, which would make the app and its healthcare services available to New Yorkers during the COVID-19 pandemic.^[29] New Yorkers can consult doctors from the New York Telemedicine Association.^[30]

In October 2020, it was announced that Babylon Health and Home State Health had partnered to launch its new Babylon 360 service to health plan members living in 10 counties in Southeast Missouri which would see Babylon serve as the primary care physician via its mobile application.^[31] In March 2021, Babylon Health expanded its Babylon 360 services in California with an investment in First Choice Medical Group which serves nearly 50,000 Medicare Advantage and Medi-Cal members. It also supports a network of 180 primary care providers and 1,000 specialty providers.^[32] In April 2021, Babylon Health acquired Meritage Medical Network, a medical group with 700 physicians based in California.^[33]

In January 2022, Babylon Health acquired Higi, a consumer health engagement firm,^[34] and DayToDay Health, a care management platform.^[35]

In January 2016, Babylon raised a $25 million Series A round.^[36] This was considered the highest raised funding for a digital health venture in Europe.^[37] Its investors include Hoxton Ventures and Kinnevik AB. In April 2017, it raised a further $60 million to develop its artificial intelligence capabilities.^[38]

Babylon's series C funding in August 2019 was led by Saudi Arabia's Public Investment Fund. It raised $550 million.^[39] At the time it was rumored that the round was due to have a cap of $400M, making it oversubscribed. Notable investors include the ERGO Fund, Kinnevik AB, and VNV Global formerly known as Vostok New Ventures.

In April 2020, Kinnevik AB reduced their valuation of Babylon due to "greater uncertainty over the roll-out of existing partnership contracts as a result of COVID-19."^[40]

In September 2020, Kinnevik further reduced their valuation of Babylon by 10% while peer companies such as VillageMD and Livongo grew by 209% and 199% respectively.^[41]

In October 2021 Babylon went public on the NYSE (ticker BBLN) via a SPAC merger with Alkuri Global Acquisition Corp, valued at $4.2 billion.^[42] Parsa later described his decision an "unbelievable, unmitigated disaster"^[43] after the share price collapsed.^[44]

In May 2022 the share price dropped from around $1.50^[45] to $1. Parsa said, "the UK government pays you to look after people in our [average] age cohort two to three times a year... in reality, people use us six or seven times a year and we lose money on every member that comes in." The company had announced a nearly threefold increase in revenue for the first quarter of 2022, to $266 million.^[46]

On June 28 2023, Babylon announced it would delist from the NYSE, transfer "core operating subsidiaries of the Company" to MindMaze SA, and stated it "will not provide for any payment to the Company’s Class A ordinary shareholders or other equity instrument holders, as AlbaCore will be exercising rights under its debt agreements with the Company to transition the go-forward business by transferring core operating subsidiaries of the Company to MindMaze".^[47] However, on August 7 2023, Babylon announced that the transaction "would not proceed" and that "Babylon is exiting its core US business".^[48] On August 11 2023, Forbes reported Babylon is “winding down” its business in Rwanda, potentially disrupting care for 2.8 Million people.^[9] On August 15, 2023, Babylon announced that they would also be liquidating in the US within a Chapter 7 bankruptcy liquidation.^[49]

There have been concerns raised regarding the governance of Babylon Health, in particular the use of misleading promotional claims and the safety and quality of the advice offered by its artificially intelligent chatbot. Critical safety concerns relating to the chatbot were raised with UK regulatory authorities.^[50][51][52]

In June 2018, the company announced that its AI could diagnose health issues as well as a human doctor, however, these claims have been widely disputed and the methods of evaluation utilized by Babylon discredited.^[53] In November 2018, a Lancet publication concluded; "Babylon's study does not offer convincing evidence that its Babylon Diagnostic and Triage System can perform better than doctors in any realistic situation, and there is a possibility that it might perform significantly worse. If this study is the only evidence for the performance of the Babylon Diagnostic and Triage System, then it appears to be early in stage 2 of the STEAD framework (preclinical). Further clinical evaluation is necessary to ensure confidence in patient safety."^[54]

The safety concerns relating to the chatbot highlighted significant gaps within the medical device regulatory framework for eHealth Apps. Currently, in the UK, AI Healthcare chatbots can be registered as a class 1 medical device (comparable to spectacles and walking frames), hence are not subject to any form of regulatory approval.^[55]

In February 2020, safety concerns relating to the Babylon AI Chatbot were the subject of a BBC Newsnight investigation.^[56] The UK's medical device regulatory body, MHRA, has acknowledged the 'concerns' regarding Babylon Health.^[57]

In April 2020, Alberta's privacy commissioner launched two investigations into Babylon, by Telus Health, over non-compliance and medical privacy concerns.^[58] The reports found that the province's health information privacy laws when ignored when the Telus Babylon App was launched commenting; "I think what we have here is an example of an app that was developed in another jurisdiction and was dropped into Alberta without due regard for Alberta's legislation".^[59]

In May 2020, Babylon Health marketed a non-MHRA-approved COVID-19 antibody home testing kit that used capillary blood (finger-prick). Abbott which developed the antibody test to work on venous samples released a statement to advise that the test should not be conducted with finger prick samples.^[60][61] The Medicines and Health Products Regulatory Agency (MHRA) asked all providers of COVID-19 antibody testing services using capillary blood collected by a finger-prick to stop providing these services and advised the public to ignore any result they get from the private kits.^{[62][63][64][65]}

On 9 June 2020, a data breach occurred in which three patients were provided with access to recordings of other patients' video consultations.^[66] Babylon Health claimed the breach was live for 2 hours and was due to a software error.^[66] Following the breach, a Digital Health investigation found that a series of technical information exposing potential weaknesses in Babylon Health's technology was freely available through a Firebase database mistakenly left open.^[67] Babylon Health's app security score was 10/100, putting it in the "critical risk" category, according to the CVSS scoring, a globally recognised standard for testing software and scoring its weaknesses. The full assessment report has been published on GitHub.^[68]

In 2017, Babylon made a legal challenge in the High Court to prevent the Care Quality Commission (CQC) from publishing a report that raised several concerns regarding the potential for prescriptions being misused and information not always being shared with the patient's primary GP.^[69] The High Court ruled against the injunction and the report was published on 8 December. Babylon has also agreed to pay the regulator £11,000 in costs.^[70]

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