Lots of companies have smart ideas. Fewer have the kind of ideas that can make the world a little bit better. Here are five startups that made big strides on their game-changing innovations in 2018.

1. OneOme 

Drug discovery isn't one-size-fits-all; the same drug can affect different people in different ways. Until fairly recently, learning how a person's body would react was mostly based on trial and error. But advances in genetics have made it easier to pinpoint the best drugs and dosages for individuals. In 2017, Mayo Clinic spinout OneOme launched its RightMed test: For $349, the Minneapolis-based company studies your genetics and creates a report that guides doctors on the therapies that are likely to be most effective for you, whether for depression or heart disease or cancer. Since your DNA doesn't change, it's a one-time fee. Earlier this year, the company democratized pharmacogenomics even more: You no longer need to visit a physician to order a test. Just sign up on the company's site; it will send you a cheek swab and an independent provider will order the test. The company has more than $6 million in funding from investors, including tech incubator Invenshure. 

2. Rocket Lab 

More and more startups want to send their cargo to space. Huntington Beach, California-based Rocket Lab can help them get there. The company performed its first fully commercial launch on November 11, sending up its Electron rocket packed with nano-satellites owned by several companies, including upstarts Spire and Fleet Space Technologies. While rockets once took months to build, Rocket Lab is speeding up production times by creating versions about a quarter the height of SpaceX rockets--and with partially 3-D-printed engines. With $215 million in funding to date, the company has a manifest of 16 flights in 2019. The idea is that the 56-foot Electron rockets, which can carry up to 500 pounds of cargo, will soon make more than 100 launches per year.

3. Aexos

Football's concussion epidemic has been well documented. While most efforts to protect the head have focused on, well, the head, Waterloo, Ontario-based Aexos has turned its attention to the neck. Aexos's Halo shirt is manufactured with a mock turtleneck made from a rate-sensitive polymer that's soft when static but stiffens when force is applied to it. In theory, that will reduce the head's tendency to jerk around when met with a blow, which is the action that causes most concussions. Aexos says the Halo reduced head movement in lab tests by nearly half. After a successful Kickstarter campaign, the startup says it will start shipping the $144 shirts in December. Its co-founders, former hockey-playing brothers Charles and Rob Corrigan--both of whom quit because of head injuries--say you'll see some big-name NFL and NHL athletes wearing them soon. 

4. Fulcrum BioEnergy

What if a single invention could eliminate 3 percent of all U.S. greenhouse gas emissions? That's the promise behind Bay Area startup Fulcrum BioEnergy. The company spent more than a decade figuring out the best way to turn organic waste into jet fuel. Earlier this year, Fulcrum broke ground on its first plant, in Reno, Nevada, where soon it will begin collecting 300,000 tons of municipal trash each year, sorting it, applying huge amounts of heat and pressure, and converting it into fuel. More plants are in the works for Chicago, Houston, and Seattle. The airline industry and the U.S. government are interested: United Airlines is an investor, and the Department of Defense awarded the company a $70 million grant in 2014.

5. Parabon NanoLabs

In April, police caught the suspected Golden State Killer by matching DNA found at crime scenes decades ago with genetic info uploaded into a database by the suspect's relative. Within a day, 22-person Parabon NanoLabs in Reston, Virginia, announced that it had been working on the same type of service--and that it was open for business. The company compares DNA in unsolved cases with publicly available genetic data, ideally matching it to a suspect's family member. CeCe Moore, a pioneer in so-called genetic genealogy, uses birth certificates, marriage records, old news stories, and obituaries to build out a family tree and pinpoint a suspect. The company, which received a $1.5 million Department of Defense contract in 2016 to develop its technology, has already helped solve more than 20 cases using the new method. Of course, the practice isn't without controversy. Before you upload your genetic data to a website just for fun, remember that it could lead to your cousin's arrest.