Babylon Health is making a big push into the U.S. with its purchase of another California-based practice. The London-based startup recently acquired Meritage Medical Network, a health system spanning California’s wine country, just months after buying a Fresno-based practice.

It did not disclose the terms of either deal.

Though it’s made a couple of other investments in the U.S., Babylon is still best known across the pond, where it offers a triage chatbot and telehealth visits through the U.K.’s National Health System.

But the startup has also faced recent questions about its business practices and the safety of its triage chatbot, after a physician noted it gave gastritis — not a heart attack — as a likely diagnosis for a 67-year-old smoker experiencing central chest pain.

With its purchase of Meritage, Babylon will gain 700 physicians. Its acquisition of First Choice Medical Group, which has practices across Fresno and Madera, brought it 180 primary care and 1,000 speciality providers. In total, it would have access to a combined 90,000 patients.

The company plans to build a service similar to what it offers in the U.K., called “Babylon 360.” People would be able to access virtual consults with internal medicine providers, pediatricians, nurses and dieticians through its app, said Marcus Zachary, Babylon’s U.S. managing director of value-based care. They would also be able to use its AI, which he described as similar to a nurse advice line for triaging.

Zachary highlighted its AI triaging and virtual consults as a key part of the company’s ability to scale, pointing to Babylon’s GP at Hand clinic in the U.K., which it grew to 90,000 members in roughly two years.

“When you stack that all up, only about 9% of the time do we need to refer a patient or member to be seen in [person], in real life. The other 91% of the time we can address the issue in the digital virtual realm,” he said, noting that up to 30% of interactions seen by the company are through the AI alone.

Regulatory questions
Currently, chatbots and similar software do not have to be cleared as a medical device in the U.S., provided that they are not used as a diagnostic tool. Similarly, in the U.K., these devices must be registered with the Medicines and Healthcare Products Regulatory Agency (MHRA), but there is no approval process.

This was expected to change last year when the EU updated how it regulates medical devices, but that never happened, since the U.K. left.

The MHRA still might still take another look at how medical devices are regulated. In a letter reported on by TechCrunch and reviewed by MedCity News, the agency admitted that it did have some concerns about Babylon.

In a meeting with regulators last year, physician Dr. David Watkins raised concerns about the safety of the device, as well as promotional claims made by the company about its AI, and a data breach that took place last year, after an app user was able to access other patients’ video consultations.

In response, the MHRA wrote “Your concerns are all valid and ones that we share,” according to the letter, written in December.

In an email, Babylon said it had never received any notification from the MHRA of any regulatory action. When asked to confirm that it had not contacted Babylon, the MHRA cited confidentiality rules saying it was unable to share information about specific manufacturers.

Photo credit: claudenakagawa, Getty Images

Correction: Babylon did not acquire hospitals through its deal with Meritage.