Rebecca Mitchell, MD

I’m a lucky man - I get to talk about stuff I care about with people that feel the same way, but know how to approach it in fresh ways. This chat with Josh Au Yeung goes into another area I think needs much more attention - leadership. NHS providers recently published data showing only around a third of NHS CEOs have a clinical background: https://lnkd.in/givrbU_p . When evidence suggests that expert leadership is strongly associated with better outcomes, happier staff, and greater productivity, we need to work harder to identify, train, and support current and future clinical leaders. The burning question is this: when it comes to #HealthTech , who is the expert leader? A technologist? A clinician? A hybrid? Would love to hear your thoughts on this (and the podcast, naturally)

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Someone broke down the estimated costs of a $15 Sweetgreen salad. We need these cost graphics for digital health to help future founders. Especially for tech enabled cos, the greatest cost is labor. Much of the "value created" is in curation and matching, which means the gross margins are reliant on labor arbitrage. Pay someone $X, but get paid $X+Y% per visit. The challenge with healthcare is that you often have to pick one of two business models: 1. specialized, low volume, high cost, low gross margin % 2. generalized, high volume, low cost, high gross margin % I'd argue founders should focus on gross dollars over the lifetime of the customer (like Jeff Bezos said) instead of gross margin %'s, but we'll leave that for another time. The challenge is that many tech enabled digital health cos have high cost of goods sold (labor) and moderately high product, design, and engineering budgets. We must build differentiated solutions for patients, clinicians, and clients to be out incumbents, however, we're realizing that companies are ultimately valued on the discounted value of future cash flows. And the high SG&A costs at most organizations might be inbalanced to the unit economics of the business. I'm not sure the math pencils out for everyone unfortunately. But I'm just a guy on the internet, would love to hear the thoughts from those smarter than I (you!). Comment below. --- p.s. I have no idea the accuracy of the graphic and not an investor in Sweetgreen. Cheers. Credit: David Crowther

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Read how StoryMD is transforming patient engagement by changing the way patients view their health data, empowering them to understand, engage, and take control.

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Day Zero dispatchs from HLTH Europe For an event that hadn't officially opened yet, there was a huge amount going on yesterday. Adequately fueled and hydrated, your intrepid avatar launched into the festivities. What were some of the highlights? HealthXL hosted an event looking at AI in Lifesciences and Pharma. They always draw a huge crowd on leaders from industry, and today was no different. Chandana Fitzgerald started with the news that they have merged with HLTH, becoming HLTH Community! Robert Garber led with a VC summary of the state of AI, and how to avoid the infamous Trough of Disillusionment. With 82% of companies looking to implement AI governance, it's a good time for those looking to make AI safe and effective. Unsurprisingly, hes also seeing greatest focus on the less complex, administrative side of healthcare. Cristina Ortega Duran gave a lively presentation on their successes with Evinova, which integrates trail data into a single platform. Stephen R. called on the audience to follow 3 rules: focus on the customer problem first, learn quickly, and follow the evidence. Yes, he's turning everyone into Product Managers. During the panel we had great questions about bias and representation from Aahuti Rai, which underlined the role that synthetic data and telehealth have to play in filling gaps and reducing the burden of trial participation. The final workshop focussed on priority use cases for AI in Drug R&D and Clinical Development. Some suggestions included Ambient Documentation for researchers, summarisation of content translation to ease recruitment, and the identification of novel outcome metrics. Shout out to whoever arranged the "AI in the NHS" session, because it was packed to overflowing. If anyone was lucky enough to find a seat, let me know how it went because I couldn't get in! After hours we had the customary networking events, including a brilliant get together from AlbionVC (thank you Molly Gilmartin!) where I finally got my chance to meet with Hello Self's Charles Wells, reconnect with AI legend and founder of Newton's Tree Haris Shuaib, Kelly Klifa & Alexandra (Sasha) T. from Ally Health, Samantha Fay from SiSU Health UK, and welcome back Dr. James Somauroo & Jessica Somauroo after their 5 week honeymoon. Given how hard they work, the absolutely deserved it. For all the clenched teeth and hair pulling that our industry can cause, today showed that the determination and drive to fix the problems we face are still there. HLTH really does know how to bring all the boys (and girls) to the yard! ALSO: Shout out to my former Babylon colleagues Nirvana Luckraj Darshak Sanghavi and Tom Breeze. The network remains *strong* #hltheurope #healthcare #innovation #digitalhealth #healthtech

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#Niche-focused #ventures in #HealthTech, such as those #targeting #underserved areas or #specific health conditions, offer several benefits. They can address gaps in the #healthcare system, provide specialized care, and #potentially integrate into broader #ecosystems for comprehensive healthcare solutions. For example, #JVEDTECHMedovation, could explore #partnerships with #niche #HealthTech startups to enhance offerings in healthcare #innovation.

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Digital health investors pulled back, but there are rays of hope... It's a similar story with startups across the gamut - things got a bit crazy there for a while, and discipline is ramping up - profitable growth is in. At MedCity News INVEST, Shawn Ellis put it well - much-needed practicality has been injected into the funding environment "Founders are paying more attention to unit economics, contribution margin, thinking critically about the milestones in their business and the KPIs they need to show all the way." Good news is that many investors want to be more than cash machines - Fatima Husain cites the Better Health example, where her healthcare connections helped the company achieve traction with major health systems. All this to say, rocky times are still ahead for #digitalhealth as things reset. But reasons to be optimistic and keep at the mission. #healthcare #innovation

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Should you sell your practice to a VC-Backed MSO Startup? tldr: - new VC-backed startups are forming MSOs to roll up independent practices - The pitch is physicians receive early liquidity from the roll up and are granted ESOP shares that can be used for retirement - Problem is the use of ESOPs with independent practices is not a new concept and has been used with large group practices since the 70's - ESOPs do not grant full ownership and in order for the shares to be valuable for retirement, the practice needs to run the same if not better post roll up - With VC-backed startups being primarily operated by non-physicians with zero clinical or medical practice experience, the likelihood of this happening is extremely low making the entire concept high risk However, there is a viable path for continued ownership + liquidity for independent practices. Check out the article to learn more. ⤵ https://lnkd.in/gmGvTYwP

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Want the inside story on what AI tools are being piloted at ScionHealth? This week I chatted with VP of Strategic Operations & Initiatives, Sarah Hughes, MSHA, MBA about how they’re using Eon, LUMINARE, and Operait Health to build out their AI toolkit. — 🟩 Q: What are your biggest tech-related priorities for 2024? 1) Workforce support—How can we deploy technology solutions that make our staff’s lives and daily work easier and more efficient? For example, we are currently deploying a technology platform, M7 Health, which has built a dynamic nursing workforce management system to help us understand and optimize each nurse’s work-life preferences with regard to scheduling and career goals. 2) Patient activation and engagement—How can we better engage and activate patients on both the front end (i.e., scheduling appointments and interacting with our organization) and the back end (i.e., continuing to engage with us to manage their health)? 🟩 Q: Where are you currently exploring AI-driven solutions? We’re running pilots to address a few different administrative and operational efficiency use cases: Incidental findings on radiology reads—We’re working with Eon to automatically scan radiology reads to identify and manage patients with incidental findings, and proactively reach out to them to schedule follow-up care. Sepsis early detection—We’re currently testing LUMINARE's platform, which implements the hospital’s sepsis protocols by automating intervention, streamlining communication, and simplifying reporting and analytics. Operating room scheduling—We’re also looking at a vendor called Operait Health which has built an AI-first solution to optimize surgical demand and right-size OR staffing by forecasting gaps in the OR schedule and placing cases unrestrained by blocks. 🟩 Q: Which areas are you most excited about the potential for new solutions? We’re excited about the potential for virtual remote care in the home on the long-term acute care (LTAC) side. We’ve already seen success with these models in our community hospitals, and we believe there’s potential to similarly deliver a better patient experience at lower cost by bringing care into the home for a subset of our LTAC patients. 🟩 Q: Any general advice for healthcare IT leaders out there? It can be easy to underestimate the legacy IT “tax” of bringing in any new vendor, given that any new solution must work with our existing tech stack. Vendors need to factor this in when discussing implementation timelines, and health systems need to ensure they include all the right internal stakeholders, including operational leaders, early in the conversation to appropriately plan for integrating and deploying solutions into day-to-day operations. — p.s. I loved this conversation because of all the practical wisdom Sarah shared. We're on the lookout for similarly insightful health IT leaders to feature. Who should talk to?

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Exciting news from Monica Chopra, Jeffrey De Flavio, MD, Samantha Adelberg, and the rest of the Auxa Health team as they officially announce their $5.2M Seed round. The team's deep industry expertise and drive for change have led them to solve critical infrastructural friction to providing quality healthcare and adoption of value-based care. Auxa's AI benefit navigation platform is simplifying the complexities of healthcare by streamlining all of the fragmented and siloed data and information to make it actionable in real-time for healthcare organizations. For the 70% of Americans who aren't getting access to the health and social care benefits they deserve, Auxa's solution will be pivotal in enabling equitable care. We're thrilled to partner with co-investors Zeal Capital Partners, AlleyCorp, Laconia, and Chaac Ventures on this journey and look to share many more milestones ahead. Cc K50 Ventures, Ryan Bloomer, Daniel Vásquez, Nick Talwar, Stefanie Ng https://lnkd.in/dPDY7-Db

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He fell in love with an AI chatbot; then built a $24M healthtech company from scratch. Now clinicians are champions of his product. (but he had 0 healthcare experience) Alex LeBrun, Nabla's CEO, shared a fascinating story with me: Years ago, he was captivated by an AI chatbot named Cybele. This "online dating" experience sparked his passion for AI. Here's how he did it with 0 prior experience and connections in healthcare: 1. Started his own clinic ↳ Invested heavily in creating a learning environment ↳ Operated in two countries to avoid cultural bias ↳ Observed real healthcare processes firsthand ↳ Gained credibility in the industry 2. Found the right partners ↳ Looked beyond conventional healthcare thinking ↳ Avoided those fixated on minor EMR improvements ↳ Built relationships with forward-thinking clinicians 3. Learned from your mistakes ↳ Acknowledged the high cost of building a clinic ↳ Used the experience to gather crucial initial data ↳ Leveraged it to build a strong clinician network 4. Focused on distribution, not just product ↳ Made the product accessible to individual doctors ↳ Let users become product champions 5. Made his product frictionless ↳ Created a simple Chrome extension ↳ Enabled instant trial without complex setup ↳ Designed for overwhelmed, time-poor doctors ↳ Prioritized ease of use over feature overload 6. Adapted the product to individual needs ↳ Recognized diverse documentation styles ↳ Allowed personalization down to user level 7. Built a community of champions ↳ Focused on delighting individual users ↳ Encouraged word-of-mouth promotion ↳ Leveraged doctors' influence in hospitals The key to disrupting healthcare as an outsider is to stay curious, adapt quickly, and solve real problems. PS: Are you an outsider with a bold idea for healthcare? Your fresh perspective might be exactly what the industry needs. Listen to the fascinating episode here: Apple Podcasts: https://hubs.la/Q02CS_300 Spotify Podcasts: https://hubs.la/Q02CTkn60 #CharmHealth #DigitalHealthDisruptors #HealthcareAI #ClinicalAI #AIInnovation #Nabla #AlexLebrun #HealthcareRevolution #Podcast #AIChampions #MedicalTechnology

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Fresh off the press: Bright news on the Digital Health/mHealth space! The Catalan Public Health System is creating a framework to make apps and digital services accessible to its 8M+ lives. This includes their own relational apps (read: your chart, appointments, prescriptions, etc) but also therapeutic apps created by 3rd parties. Today they have published the Best Practices Guide to Develop Health Assets for the Public Health System (Guia de Bones Pràctiques per desenvolupar actius digitals per a la ciutadania). Link in comments The guide provides a framework with the requirements to have apps and other digital services integrated (and covered!) by this public payer. All of us in Digital Health understand the need for structure and transparency when dealing with payers. Carme Pratdepàdua Bufill and team at TIC Salut Social Foundation, and Joan Guanyabens Yolanda Portero Elisenda Serra Masip thanks for your leadership in delivering this exhaustive and necessary work. This spirit of ecosystem and partnership is rare in this industry. Can't wait to see the impact this will make in providing equitable access to health and better outcomes for the citizens of Catalunya. #healthequity #accesstohealth #DTX #digitalhealth #publichealth

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Interesting to see that digital health funding is relatively stable. Only a couple of exits. I think we'll see more deals like DarioHealth's acquisition of Twill, since from a sales perspective, the narrower the solution, the more difficult it is to acquire customers. This difficulty has nothing to do with the quality of offerings, but with the data management and administrative complexity on the customer side.

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-In Q1 2024, U.S. digital health startups raised $2.7 billion across 133 deals, reflecting a decrease from previous quarters -AI-led digital health firms drew significant attention, securing $1.1 billion, representing 40% of the quarter's total funding -Despite a challenging economic landscape, the focus has shifted towards startups that demonstrate strong outcomes and value for investment, emphasizing the importance of solid performance metrics over mere growth potential. #digitalhealth #healthcareai #venturecapital

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Two companies in the Kidneyverse orbit are joining forces to leverage the power of human touch to unlock the "last mile" of social impact and cultural connection. SameSky Health is merging with GroundGame.Health, which closed a $17 million funding round led by 7wireVentures after the companies joined. The combined company will accelerate a shared mission to improve health and advance health equity by closing the loop around health-related social needs and gaps in care at scale. Together, their coverage spans all 50 states. [1] SameSky is a DaVita Venture Group portfolio company. We also shared an article in last week's Across the Kidneyverse written by an investor from 7WireVentures that (naturally) referenced GroundGame as a noteworthy examples of a digital health company embracing local communities and on-site services. Other examples mentioned included Live Chair and Waymark. [2, 3] Speaking of social determinants, you might have seen the Fierce Healthcare article sharing how Papa is looking to drive deeper support for insurance plans through new offerings focused on Star ratings and SDOH. The company is pitching Papa as a way for health plans to improve their Star ratings—by enlisting pals to drive members to annual wellness visits and preventive disease screenings. [4] Is it just me, or can we find some way to adapt and scale these programs for people, households and communities impacted by kidney disease? We have a home dialysis bill in the mix, a new FDA VR/AR Home as a Health Hub project, and a push for more last mile, in-home support. [5] How long before these trends come together and make a dent in US health/care? Let us know what you think! 👇🏼 Sources: [1] https://lnkd.in/gqKjfWSF [2] https://lnkd.in/gNFmJ8Pr [3] https://lnkd.in/gz_-PSaM [4] https://lnkd.in/g-Rj998A [5] https://lnkd.in/gh9gt8Cd

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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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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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🎙️ Calling all #healthtech #entrepreneurs, especially those in the #femtech space! 🚀 Design is at the core of impactful products and successful companies. In our latest podcast episode, Theresa Neil, an award-winning #productdesign professional and founder of Guidea and Femovate by Guidea, dives deep into the world of product design in #healthtech. Key Takeaways: - The future of health tech: physical-digital convergence. - User constraints: a vital consideration for providers and consumers. - Strategies to evaluate competition and stand out in the market. - Insights on designing for inclusivity and accessibility. -What consumers should know about women's health products - Emerging trends in femtech for your next breakthrough idea! 💡 Whether you're an aspiring #founder or curious about women's health innovations, this episode offers valuable insights and real examples of products making a difference. Tune in to gain knowledge and inspiration! #healthcare #innovation #podcastepisode https://lnkd.in/gFk8i5iQ

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The VC defensibility argument for rejection is an empty reason to reject a company, because it ultimately comes down to execution. I understand the argument if a company sells iPhone cases, and that business really is completely indefensible given that others can very easily copy it (for almost nothing) sell fakes, have scale, and IP law can't really do anything here, etc. But is then SpaceX indefensible because Lockheed and Boeing and Blue Origin (who all have billions), can do the same. So why don't they? Why haven't they? It's because it's really hard to do. Defensible businesses are businesses that are really hard to build. The same can be said in banking. Does Revolut also have a defensibility issue? I'm sure they got rejected by investors for this reason many times. There were dozens of digital banks, but there is now 1 leading digital bank. Their defensibility is scale. And that's really hard to do. Defensibility is an ignorant argument, and it's often coming from those that have never actually built a business.

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Digital Health: Countervailing Forces… Consider this: over the past five years nearly $78 billion has been invested in digital health companies and yet just this past year over 20 million Americans were taken off the Medicaid rolls. Certain policy changes can be very damaging, to say nothing of other human-induced factors like pollution, climate change, wars, inadequate housing and education, and hunger which have staggering implications on health. At times it can feel like bailing water out of a sinking ship.    The overall venture capital activity in 1Q24 was a relatively muted $36.6 billion across 2,882 companies for an average round size of $12.7 million, as compared to $51.6 billion and 4,026 companies in 1Q23. Notwithstanding that the level of investment activity in the healthcare technology sector has receded from the $30 billion highwater mark in 2021 to a more manageable $10 – $12 billion annual pace, the opportunities to “transform the business of healthcare” remain obvious and acute. Arguably, the 2021 hangover still lingers in the healthcare technology sector as companies that raised too much capital at too high a price work to sort out challenging cap tables. Out of the 2021 mosh pit of too many companies, it appears that the sector is in an “Emerging Winners” phase that will drive companies with narrow and/or incomplete offerings to combine or shut down.   Thoughts on what to expect for the remainder of the year… https://lnkd.in/egy7Afhg Flare Capital Partners #digitalhealth

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