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Recuro Health Enters Genomics Market With MyLegacy Purchase from Cleveland Clinic

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CHICAGO – Startup Recuro Health has entered the genomics market with a pair of acquisitions.

Last week, the Dallas-based company announced that it had acquired Family Care Path, a Cleveland Clinic spinout that makes MyLegacy, a web-based clinical decision support and risk stratification application for genomics.

CEO and founder Michael Gorton also said that Recuro Health recently acquired another genomic testing asset that he did not specify. He said that Recuro will make an announcement on that front in the next 30 to 45 days, adding that the firm is looking at one more genomics acquisition in the near future.

Recuro incorporated in January, though Gorton and John Halsey, cofounder and chief growth officer, actually started the company at the beginning of 2020. Gorton, who called himself a serial entrepreneur, previously cofounded telemedicine company Teladoc Health in 2002 and led it until 2010. Halsey also was a Teladoc executive in the 2000s.

In late March, Recuro announced a seed funding round for an unspecified amount, led by the Oklahoma Life Science Fund. Cortado Ventures, 1843 Capital, and Sage Venture Partners also participated in the round.

Recuro calls itself a digital health company, though Gorton said a better description might be "digital medical home." The medical home, sometimes called a patient-centered medical home, is a concept that emphasizes care coordination and prevention through all stages of life, particularly between doctor visits.

Ever since he left Teladoc, Gorton said he has been thinking about how to improve healthcare in the US. He said he has long been irked by the fact that the nation's "healthcare system" is more of an episodic sick-care system, where people only engage with medical professionals when they have an ailment.

Gorton called genomics "important" to fixing that problem.

"First of all, it gives us a baseline to understand the biochemistry tendencies" of an individual. But he sees even greater potential in disease prevention and in the targeting of care.

"As we go down this genomics trail, we're going to see the ability to use genomics to help people lose weight, to find the right medication when there's three available to them," Gorton said. "We're going to be able to use genomics to help athletes fine-tune to increase longevity [in their careers]."

Added Gorton, "I'm a huge believer that [genomics] has to be the foundation."

He said that Recuro's mission is to harness the underused potential of all the assets in this disjointed healthcare industry to create a true "system" that emphasizes prevention, early detection, and precision care.

MyLegacy is an important piece toward fulfilling that mission.

MyLegacy uses algorithms based on practice guidelines developed by the Cleveland Clinic Genomic Medicine Institute to collect and analyze patient-provided data on personal and extended family history to generate a genetic risk assessment for specific conditions. Family Care Path held an exclusive license to the technology. 

Daniel Sullivan, an internal medicine physician at Cleveland Clinic who led the team that built MyLegacy, said that there has long been a problem getting family histories into the patient record. MyLegacy combines history with genetic test results and presents this information together.

"Genetic testing has really come a long way. It is far more accessible, far more affordable, but by itself, doesn't provide all the information we need," Sullivan said. "When family history is part of the equation, that's where the sweet spot is."

Sullivan said that no one knows their own family history better than patients themselves, but the information might not be completely accurate or may not be communicated properly to the doctor or delivered in a timely manner at the point of care.

An app like MyLegacy lets patients collect and enter family history online from home through Cleveland Clinic's patient portal rather than trying to remember everything to write down on a clipboard when arriving for a doctor visit.

"On occasion that patient needs to do some homework and then that homework never really gets back to us in a timely fashion, so it never gets into the record," Sullivan said. "This type of program gives the patient an opportunity to open up [genomic information] in their electronic medical record on the portal that we use here at Cleveland Clinic."

Sullivan noted that many primary care physicians either lack the expertise or the time to decide on what type of genetic testing is appropriate based on family history. MyLegacy not only provides clinical decision support to select the proper tests but also has a secure video platform to connect patients with genetic counselors once results come back.

"This is allowing patients to be partners with us to make the family history less static and more dynamic," Sullivan said. "Inevitably, patients who get engaged in their healthcare are going to have better outcomes."

According to Gorton, MyLegacy not only helps Recuro with patient "intake," it brings with it a bit of the prestige attached to Cleveland Clinic. Although the plan is to bring all of the acquisitions under the Recuro name, Gorton said that he will lean on the Cleveland Clinic brand name "to the extent that we are legally allowed."

Family Care Path will be a business subunit of Recuro and the MyLegacy name will remain in the short term, but the firm generally will use the Recuro brand name for its genomics products and services, according to Gorton.

In early May, Recuro announced that it had acquired UDoTest, a software developed to match physicians, payors, employers, and patients with labs that offer self-collection testing services for more than 80 diseases. Of late, UDoTest has concentrated on SARS-CoV-2 tests that have received Emergency Use Authorization from the US Food and Drug Administration, as well as antibody tests for the coronavirus.

"The best way to deliver genomics is to the home. Why have somebody come into a lab?" Gorton said. Recuro is now marketing the COVID-19 testing service to employers looking to bring employees back to worksites safely, though Gorton said that demand for that should wane in the next few months. "But right now, there's a huge opportunity, and not many people can deliver on a quick engine for COVID back-to-work," he said.

Beyond COVID-19, Gorton sees UDoTest as the mechanism for delivering home genetic test kits ordered by physicians during telemedicine encounters.

Gorton also talked of a "conceptual piece" of his genomics plan that integrates and analyzes genomic and epigenetic information from various locations to make it easy for end users — primarily clinicians — to understand. Recuro is not a direct-to-consumer company, so users will come through employers, aggregators, payors, or health systems.

Gorton said that there are everyday health problems that Recuro can address immediately by developing genomics panels, such as weight loss, then delivering the results with interpretation to patients through a mobile app. "We can move the data to their smartphone in the simplest app possible that tells them to eat this, not that," he said.

The Recuro CEO talked of the "extremely smart people" at Cleveland Clinic who developed and promoted MyLegacy.

"My role as a CEO-entrepreneur is to find those smart people and develop a pathway and get the assets they need to take that which is in their head and make it happen," Gorton said. "That's what we did at Teladoc, and that's what we're going to do at Recuro."

Cleveland Clinic interfaced MyLegacy into its Epic Systems electronic health record, but the platform is compatible with other systems. For example, it is available from the app store that EHR vendor Cerner maintains for its users.

In 2019, Family Care Path entered into a partnership with Shivom to make MyLegacy available through the German genomic data storage firm's online app marketplace. Shivom users can access MyLegacy to schedule a video genomic counseling session.

Gorton said Recuro is in the process of acquiring an unspecified data aggregator to integrate MyLegacy into the Recuro platform as well as into other EHRs and other software ecosystems.

That aggregator also has a roster of 500,000 consumers to whom it offers discount dental and vision benefits and health services, including televeterinary options, according to Gorton. "As we acquire that asset, we will roll the genomics pieces into it," he said.

Those genomics pieces will include a molecular panel that Recuro plans on adding through the recently acquired firm that Gorton has not named.

Beyond genomics, Recuro recently bought SupDoc, a startup that supports virtual behavioral health and virtual primary care.

Gorton said that Recuro eventually will be looking to acquire other companies that are cash-flow positive. "It may be difficult for people to see exactly what our end target is, but it's just little tiny zigzags to bring in cash-flow assets and cash-flow contracts as we aim towards this end game of being a healthcare system, not a sick care system," Gorton explained.

"We're going to take a capitalist perspective and find pathways that come to our end goal of lowering medical costs by catching things before they become expensive," Gorton added.

In the near-term, though, Gorton said that Recuro is probably done with acquisitions, but may be interested in buying a molecular lab if the right opportunity comes along.

"If I can find a way to do it economically, I'd like to have a lab," Gorton said, but it is not a necessity.

"Then I would have the Cleveland Clinic's [patient] intake. I would have the tools that take all the data and deliver it in a simple form to the end user, and the lab that can process those," he said. "If I can find a lab that brings me the value, then we'll look at acquiring one."

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