Rosina S.

This 👂 podcast episode and insight’s from a16z Bio + Health's Julie Yoo spoke so clearly to the fundamental challenge facing both 🩺 clinicians and 🏥 healthcare systems.  There is a huge disconnect between supply, in the availability of clinicians, and demand, in the increasing volume and complexity of healthcare needs. -     36% of physicians plan to reduce their hours next year according to the AMA -     48% of physicians reported feeling burned out in a 2024 Medscape survey At the same time, the demographic baby boomer bubble and steady increase in the prevalence of major chronic disease, which consumes up to 90% of healthcare expenditures according to some estimates, is driving demand. With this context, Yoo points to a major opportunity for AI adoption in healthcare in 2025. Yeah, a VC hyping a wave of new AI companies that will replace the decades of training and experience of clinicians, the skeptic would say.  But Yoo is thoughtful in pointing to the role AI can play, and is already playing, through solutions such as ambient, autonomous scribe solutions (of which local star Abridge is leading the pack) in not replacing, but freeing up productivity for clinicians. There is so much unstructured context in both the complexity of disease and treatment options and the social/emotional considerations that we shouldn't be looking for AI to *replace* clinicians. But companies are getting better at finding the structured, repetitive and time-consuming places where AI tools can *help* clinicians. Nearly two-thirds of doctors cited bureaucratic tasks as the leading contributor to burnout. Rigorously trained-AI driven solutions can be a force multiplier for clinicians, and I’ve seen several interviews where nurses and doctors go as far as to say some of these solutions are ”restoring their joy in practicing medicine”. Our health is precious; and we rightly want any technology engaging with it to be developed thoughtfully and thoroughly tested. This requires top AI talent and diverse and realistic training data. Pittsburgh’s strengths in both areas is why we are an emerging hub for data-driven healthcare. #AIinhealthcare #clinicianburnout #healthinnovation #digitalhealth

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Alot of bad actors and a few good actors. $2.5T HC capital raised & $1T invested by PE in last decade. $31B in 2013 vs. $217B in 2021. We know the story. Misaligned incentives - unrealistic multiples, short-term profit focus, aggressive cost-cutting, unrealistic scaling, misunderstood market dynamics, just to name a few. However, our industry needs money. But our industry is more infrastructure asset class than tech start-up (James Nicholls gave me that epiphany). Mic drop on the lyrical genius of Alex Fair of MedStartr Ventures as he literally gives the whole story poetic justice as he reads HIS POEM on this "On The Road at VIVE" episode of The Reverse Mullet Healthcare Podcast w/BP2 Health. This is the perfect episode for a Friday afternoon! He and Paulo J Machado donned the actual reverse mullets and joined us back in February at #VIVE2024 to talk about the need for REAL change in healthcare, startup focus and investor expectations. It was one to remember and one that is in desperate need of a full-length follow-up episode. Give us a like and a watch or a listen https://lnkd.in/e4w4mjkv https://lnkd.in/egmK3kMB

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As the discourse shifts from models to compound AI systems / agents, we need better AI benchmarks to evaluate multi-modal and multi-step task performance, especially in healthcare and life sciences. When we wrote the first paper demonstrating ChatGPT's performance on the USMLE, we chose the US Medical Licensing Exam as a benchmark for accessibility, speed, and ease. This benchmark was never intended to represent AI model performance on real-world clinical tasks. Today, I still see so many research teams and startups using benchmarks (like the USMLE) that are ill-fitted for assessing the true clinical or scientific performance and utility of the models they are developing for real-world contexts. Benchmark development may be seen as a "less sexy" area of research, but it is of paramount importance. Years after the rise of the transformer, we still lack adequate benchmarks for so many single-step tasks in biomedicine. With compound AI systems (i.e., architectures that integrate multiple AI models to perform complex tasks) emerging, we need new benchmarks for agentic behaviors. I'd argue that developing an agent with novel capabilities without at least proposing a companion benchmark (if an industry standard does not yet exist) may hinder the adoption of said agent, especially for high-stakes workflows. Designing more benchmarks that capture/simulate real-world clinical and scientific workflows will help us mitigate the major discrepancies observed between in silico and in vivo performance and better support safe + effective deployment of AI in biomedicine. There are already brilliant people focused here, and we need more. DMs are open if you're researching or working in this area of multi-step/multi-modal benchmarking in healthcare and life sciences! #healthcare #ai #artificialintelligence #generativeai

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With $8.2B invested into digital health so far, 2024 is shaping up to be a $10-12B annualized investment year. This would make funding comparable to 2023. I suspect with continued venture investment, boards will require exits. One thing I’m particularly interested in is terms of recent acquisitions and growth equity rounds. What type of downside protection (e.g., structure) is not disclosed to media that protects the investor? Will funds who have specifically raised capital to buy stakes in VC-backed companies at significant discounts? And what revenue/EBITDA multiples are looking like for M&A in 2024/2025? Every founder has to spin their story in a positive light when speaking to media. I know this because PR agencies reach out to me about their clients (p.s. I don’t consider myself a member of the media). The private health tech market feels like it could significantly rip or drop in the next 12-24 months. Therefore, my general advice to early-stage founders is to assume you will not raise capital beyond your seed round. If the investor market heats up in 2025, you will have the option to raise a series A at that time if you’ve built a strong business. If you’ve already raised series c or beyond, then one of your goals will be to time the exit (M&A or IPO) appropriately so that you garner an attractive multiple. There are few private health tech startups that have founder board control, can reinvest positive cash flows, and stay private forever. So by necessity of the structure, exits are desired. - - - - Image Credit: Rock Health

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AI and Med Tech in Focus   Implantable Device Reverses Opioid Overdoses Researchers at MIT and Brigham and Women’s Hospital have developed an implantable device that detects and reverses opioid overdoses by autonomously administering a dose of naloxone. Naloxone is a drug that binds to opioid receptors and blocks the effects of heroin, fentanyl and other opioids. Called iSOS, the device has sensors that continuously monitors a user’s respiratory rate, heart rate, body temperature and blood oxygen saturation and uses machine learning algorithms that are trained to recognize the signs of overdose using the cardiorespiratory data collected by the sensors. When the device detects a suspected overdose, the device buzzes and sends an alert to a user’s phone. If the alert is not cancelled, iSOS administers a rapid shot of naloxone.  The device is about the size of a stick of gum and implanted under local anesthesia. It has a wireless rechargeable battery that lasts 14 days and a 10-milligram refillable drug reservoir. ISOS has been shown to be effective in reversing the effects of overdose 96% of the time and could help people who are at the highest risk of re-overdose. Because the naloxone dose is automatically delivered in a “closed loop” survival is not predicated by timely intervention of a first responder or a bystander Further research is being done to miniaturize the size and optimize battery life. VC Investors are always adjusting their "Play Book" with a variety of options for investing. Mikal Ventures is one of those alternatives, offering curated solutions to real world problems. Reach out if you have questions on how we can be of assistance and bookmark https://mikalventures.com/ for additional insights and information.

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Here's another fundraising roundup spotted in the healthcare wilds 👀 🍃 ✅ Sword Health raised $130M (new valuation: $3B). ✅ Better Health raised $14M to deploy expanded payer partnerships. ✅ Alzheon, Inc. | Preserving Future Memories raised $100M Series E to advance development & commercialization of its Alzheimer’s treatment. ✅ CinRx Pharma raised $73M to continue its ‘Hub and Spoke’ model of startup formation. ✅ Eko Health raised $41M to scale AI-driven heart and lung disease detection. ✅ Anterior (formerly Co:Helm) secured a $20M Series A to unlock admin efficiencies for healthcare payers. ✅ SamaCare raised a $17M Series B to scale specialty drug prior authorization platform. ✅ Plenful secured a $17M Series A to streamline pharmacy operations with AI-powered workflow automation. ✅ Grayce raised a $10.4M Series A led by Maveron amid a caregiving crisis. ✅ Stitch Employment Services Inc PEO raised $8.75M in seed to support independent medical practices. ✅ Posterity Health secured $6M to fund expansion and technology acceleration. ✅ Sware raised $6M to accelerate life sciences innovation by automating FDA-mandated software validation. ✅ Keragon raised $3M, as announced in @Conno Christou’s LinkedIn post. As always, if I missed you, let me know! Each week I'm spotlighting an innovative healthcare startup. I just ask for a bit more transparency. All submissions are confidential; submit yours here 👇 https://lnkd.in/gF4DrAvJ Looking for more fundraising roundups, alongside healthcare industry news and analysis? Subscribe to Hospitalogy, my 2x/week newsletter. Join 33K+ other investors, executives, and healthcare professionals: https://lnkd.in/g-nfRqW6

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M13 is thrilled to lead the Series A in RadiantGraph which is focused on personalization in healthcare. As we continue to invest in early stage companies it is abundantly clear that the biggest indicator of success is the founder and his or her ability to execute on their vision of the future. In this case, I don't think I have seen much better founder-market fit than we have with founder and CEO Anmol Madan. We believe in his vision: in order to have the best patient outcomes in healthcare we need increased personalization and AI is the breakthrough to get us there. Anmol started one of the pioneering digital health companies Ginger and then was Chief Data Scientist at Livongo and Teledoc. He has done it all: early stage, late stage, public company. And he deeply understands the nuances of the healthcare market from all angles which is critical for success. While there are many players building healthcare-specific AI capabilities, RadiantGraph is focused on outcomes: The platform is already processing personalization models for more than 3.5 million people, despite launching just last year. Excited to partner with my friend Adam D'Augelli and the great True Ventures again and Morgan Blumberg who has been deep in the healthcare market with me for many years. More on our thesis in the blog below. https://lnkd.in/evDDmC3W

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These unique advantages in venture capital are indeed compelling, which raises the question: Why haven't they been widely adopted in the industry? We can distill the resistance down to a few key misconceptions: 1. **Overreliance on Capital Influence**: The belief that "Having capital is sufficient to drive change" often leads to an external, top-down approach that may not align with the realities on the ground. 2. **Underestimating Physician Business Acumen**: The outdated notion that "Physicians lack business prowess" has been repeatedly disproven by numerous real-world examples across generations. 3. **Overvaluing Back Office Capabilities**: The assumption that "Our back-office provides superior insights and analysis" is flawed. In reality, the same fundamental principles apply across the board: successful exits, founder intelligence, robust deal flow, and iterative processes that optimize analytical costs. These misconceptions hinder the adoption of game-changing approaches in venture capital.

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Imagine swallowing the competition whole. That's what many players in tech do via roll-up strategies, gobbling up smaller firms to deliver richer solutions and amass greater market share. Where else are roll-up strategies common? // HEALTHCARE Picture being a patient at a medical practice that’s been part of a roll-up in Healthcare Services. It's an industry ripe for roll-ups due to its fragmented nature and potential for greater efficiency. // CONSUMER SERVICES Or let's say you needed your HVAC serviced, and notice your local repairman is now part of a bigger Consumer Services entity? Centralized management and scale economy turn these localized businesses into roll-up targets. // FINANCIAL SERVICES Think about your insurance agent or wealth management advisor. They're working in complex, highly regulated environments. In the Financial Services sector, roll-ups offer an effective way to consolidate expertise, streamline operations, and enhance customer offerings. // MANUFACTURING Now, imagine driving past factories under a new name — the result of Manufacturing and Industrial Services roll-ups. Bulk purchasing reduces costs, enhances production capabilities, and expands geographical footprints. // REAL ESTATE Lastly, envision your real estate brokerage firm. The industry sees roll-ups as a strategic move to increase market penetration, enhance service offerings, and hike up portfolio value. Roll-ups play a huge role in most industries, rather like a snowball rolling downhill, gaining momentum, and size. Are you seeing roll-ups in your sector or considering M&A?

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Burnout is a reality for so many founders in medtech and healthtech, and it’s not talked about enough. I’ve seen firsthand how the weight of building and scaling a company can take its toll on even the most resilient leaders. That’s why solutions like fractional partnerships can be a game-changer – providing much-needed support without adding more to your plate. If you’re feeling the strain, know that you’re not alone, and there are ways to lighten your load. Feel free to reach out.

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A regulation is nothing more than entranchment of error into a system. CON laws? Administrative regulatory bodies? Value systems decided in closed door sessions? Healthcare has so much entrenched error it has limited innovation. Is this by design? Wanna see the $2 imaging exam? The $.35 cancer drug…remove entrenched error.

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To follow up on Dede Ainbinder recent post: If we use the current EHR data to build a AI clinical decision support tool it is unlikely to capture our clinical decision making process. EHR's are inherently designed to maximize billing and minimize risk of litigation. A clinical decision support tool based on this data will likely do the same. There is a large sunken cost fallacy here where we continue to hang on to garbage data. Just because the data gathering and storage process was capital and time intensive doesnt mean the data is valuable. To truly capture the clinical decision process we need to capture data which sits outside billing and litigation. Its hard to imagine a future where this data isnt used for billing and cannot be called upon during litigation. #EHR #healthdata #clinicaldecision

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10 mid-market PE deals from the past week: ➡️ Vector Capital Management has acquired Bigtincan Holdings, which provides sales enablement software and AI solutions. ➡️ Argosy Healthcare Partners sponsored a recap of Nicklas Medical Staffing, a FL-based staffing firm for pathology and histology labs ➡️ Platinum Equity invested in Global the Source, a master distributor of HVAC/R components, with will be merged with existing Platinum portfolio company MARS ➡️ RECOGNIZE invested in SDG Corporation, a CT-based provider of cybersecurity services ➡️ CES Power, a live events infrastructure firm owned by Allied Industrial Partners, acquired Base Craft | Nationwide TV and Film Equipment Leasing, a provider of services and equipment for the motion picture industry ➡️ OpenClinica, a MA-based portfolio company of Thompson Street Capital Partners, acquired BuildClinical, a NY-based provider of patient recruitment software for academic researchers ➡️ Comvest Private Equity bought Bland Landscaping Company, an NC-based provider of commercial landscaping services ➡️ Morgan Stanley Capital Partners agreed to buy Prescott's, a CO-based provider of outsourced clinical engineering services ➡️ Priority Courier Experts Express, a Minneapolis-based portfolio company of TRIDENT acquired Indiana's NOW Courier Inc. ➡️ TTDS Thermal Technology Distribution Solutions, a Cincinnati-based portfolio company of Gryphon Investors, acquired Applied Thermal Systems of Minneapolis ➡️ Echo AI (acquired by Calabrio), which uses generative AI in a customer conversation platform, was acquired by Thoma Bravo-backed customer interaction analytics specialist Calabrio, Inc. ➡️ Amulet Capital Partners, LP acquired Theoria Medical, a managing service org for senior living communities #PrivateEquity #MergersandAcquisitions #Acquisitions #PE #Acquisitions

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Excited for our webinar tonight: Investing in Healthcare Startups: An Angel Perspective When: tonight at 6 pm eastern Where: https://lnkd.in/dPUFNbhe We had had a couple last minute changes and I am very excited to have an engaging conversation with Thanasi Tsiodras, Dr. Shaun Kuan and Regina Prasad, MS. We will be discussing: 1. How to start investing in startups 2. Lessons from your winners and losers 3. What are some red flags in a startup 4. What is your diligence process like? 5. How do you get deal flow?  6. What is the ideal angel investor archetype? Who should invest in startups and who shouldn't. #healthcare #venturecapital #angelinvesting

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A whirlwind of activity last week at the America's Physician Groups conference. Lots of solid insights shared by health system leaders. Some notable thoughts: +++ Artificial intelligence is intelligent in different ways: By now, we all know ai has a diverse set of use cases, incorporated in different applications and tools. But there are fundamental differences in how the intelligence itself is brought to life. Examples include: - Predictive AI, used to forecast future outcomes by leveraging historical data. Shout out to UCLA’s CKD/ESRD early intervention protocol (Joycee Berin) and Diagnostic Robotics’ intelligence care post-dicharge journeys (Kira Radinsky) - Protocolized AI, used to automating a user’s administrative load by using a set of detailed, pre-defined rule sets. Thanks to ARC for sharing their experience using Elaborate 's automated outpatient lab summaries (Manish Naik) - Generative AI, used to create new content. Great overview of ambient documentation at MGB as well as Cedars’ Sinai talking through its medical ontology model powering acute triage (Caroline Goldzweig) Across system leaders and experts, there was clear agreement that the first step to implementing intelligence intelligently is defining the ‘jobs to be done’. That way, internal and external stakeholders are clear on what they're solving for when they architect the solution.  +++ Scaling AI takes time and rigorous observation: Market leaders describe a phased pilot approach that allows clinicians to build confidence and system leaders to measure ROI before deploying systemwide. Loved hearing Rebecca Mishuris outline MGB’s novel approach of piloting two solutions against one another, to pressure test implementation, workflow, and value creation. +++ Proving ROI continues to be challenging: Lots of vendors using lots of different metrics to prove value, but the majority of leaders agreed that estimating the ROI of these new tools today is part science, part art. Demonstrating the ROI of the “soft” metrics around provider burnout and retention seemed to be a big opportunity, especially for investment in more efficient primary care and PCP wellbeing. After all, PCPs drive referrals to specialty-level care (and higher reimbursements) for health systems. Appreciated Anurang Revri's overview of how working team setup can also impact ROI estimates. +++ Value-based care = tools + humanity: VBC will require not only implementing tools to support clinical documentation, risk capture, upcoding, etc, but also humanizing interactions to engage patients. Countless examples, but one that made me smile was a depression focused chat bot responding in the following interaction: - Context: post-discharge check in Bot: Hi Freida, how are you feeling today after your surgery?  Patient: I’m having a tough time, am in a lot of pain.  Bot: Well, it can’t be that bad, I’m sure it will get better with a positive mindset!    🤣 🤣 🤣 Can't wait for next go-around!

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I always read Rock Health's digital health reports as they give a nice pulse feel for what is happening in the digital health funding space. Good to see funds raised in H1 2024 suggest funding in the sector seems to have stabilized at 2023 levels. Its no surprise the report emphasis the buzz around AI and healthcare. There have been clear winners in the AI healthcare space in the area of process and cost optimization and the R&D space. The impact of AI in care and treatment delivery is so far much more muted. One area I never though to look at AI was in its ability to bring together multiple healthcare pathways and digital point solutions into a more holistic seamless experience for the patient. There is a clear trend away from using stand alone digital health point solutions, and could AI address this challenge by facilitating the efficient integration of disparate processes and technology into unified care programs. I can see this happening with digital health products but this will be more tricky to do with physical care programs involving clinicians and HCPs. “AI is helping us combine multiple parts of the care journey, across all care experiences. In the future, benefits navigation, clinical guidance, and care delivery won’t be delivered by separate companies or point solutions within the healthcare ecosystem. They’ll be features that work in concert within products, and they’ll happen in under 90 seconds for a seamless patient experience.” – Glen Tullman, CEO, Transcarent and Managing Partner, 7wireVentures

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The biggest topics in healthcare last year? The two Gs. GPT and GLP-1s. We’re continuing to innovate our GLP-1 care track, which includes personalized care from care teams supported by AI tools, that can help maximize outcomes for someone on a GLP-1. And what’s to come? I expect this year we’ll see: ⭐ Measuring digital health programs will shift (check out Omada’s VOI report for more on this) ⭐ Consolidation in the market - not all digital health companies will survive ⭐ An uptick in PBM and health plan partners to help employers offer GLP-1s with sustainable coverage plans Anything I missed?

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Which founders fit the mold for success in healthcare? I spoke with Anne DeGheest, Founder and Managing Director at HealthTech Capital, about the key characteristics of successful #healthtech entrepreneurs. Listen to the full conversation here: https://lnkd.in/eqwUCkPx

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