Sirj Goswami, PhD

One key reason why healthcare technologies like AI, telemedicine, and software haven't structurally lowered costs or broadened access for the entire system after decades of experimentation (excluding pure financial engineering of payer contracts) is the limited reimagining of care delivery itself, with asynchronous telemedicine as a notable exception. In the same way that digitizing physical paper failed to exploit the capabilities of a new computing medium for word processing, hosting physician-patient conversations over video does not transform the actual delivery of care. In telemedicine, many of the inputs (e.g., clinician time) and therefore cost structures of in-person care persist, which is why we often see fee-for-service telemedicine companies struggle to achieve economies of scale (i.e., growing revenues non-linearly while growing costs linearly). Until we deconstruct the components of a medical appointment – from intake and triage, to chart review, history gathering, physical examination, diagnosis, treatment, and follow-up – we will continue to be underwhelmed by the disconnect between the transformative potential of these technologies and real-world patient/system impact. I’m optimistic that the emergence of reliable and performant medical AI agents will urge us to perform this deconstruction and redesign the fundamental building blocks of a “medical appointment.”

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Hot off the pre-print server – an important publication authored by the Atropos Health team exploring the performance of LLMs in answering real-world clinical questions. LLMs excel at summarizing and contextualizing existing literature, but cannot generate de novo medical evidence today. The results of the study highlight performance gains attributable to injecting novel, relevant, and up-to-date medical evidence into LLM-powered clinical decision support systems. Brigham Hyde Nigam Shah Saurabh Gombar Read the study here: https://lnkd.in/ecuU25Pq

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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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Big healthcare AI news yesterday as Tempus AI received the first-ever CPT code for an algorithm-only analysis of previously-sequenced, laboratory developed test transcriptomic data. TLDR: AI molecular phenotyping has a new business model. The PurISTSM test uses RNA profiling to identify molecular subtypes in patients with advanced pancreatic ductal adenocarcinoma, which may inform first-line therapy selection and management. While I'm skeptical that payer balance sheets are going to solve the "who pays for healthcare AI" problem, the reimbursement pipes for clinical AI are maturing. I am surprised to see more progress for usage-based vs. performance-based models given the many challenges with FFS economics. It will be interesting to see how payers assess the "medical necessity" and therefore reimbursability of clinical AI as these models come to market. https://t.co/eLe18SmihV

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On the latest Vital Signs, Nikhil Krishnan and I had a ton of fun chatting with Dr. Atul Butte. Dr. Butte is a professor at UCSF, Chief Data Scientist of the UC Health System, and a co-founder of numerous healthcare startups. In our conversation, Dr. Butte shared his takes on healthcare AI opportunities, challenges, hype, and more. A few highlights: ⚡LLM use cases, data, and growth LLMs are already helping to solve the “drudgery” aspects of medicine, such as automatically drafting SOAP notes and patient messages. Dr. Butte is excited about future applications of LLMs that can help with the “cognitive” aspects: with difficult medical problems an LLM might be able to stitch together disparate pieces of information to generate a potentially novel solution. He also highlights that prompt engineering will become the next “coding language” as so much of leveraging LLMs is knowing how to ask them the right questions. Additionally, Dr. Butte discusses how since 2016, UCSF has been working to deidentify its patient notes so that it can query them to answer clinical questions and ultimately enhance patient care. ⚡The need for patient-facing AI As patients are increasingly able to access their own personal health data in nicely structured formats (e.g., EHRs, wearables), they desperately need more tools to help them interpret and make decisions using that data. Dr. Butte understands that these patient-facing solutions are challenging to get funded but he emphasizes that patients need to receive the benefits of AI sooner. ⚡Evaluating healthcare AI solutions In order to evaluate AI solutions, we often put human specialists – such as medical professionals – on the same tasks. Understanding that specialists often disagree with each other, a significant challenge arises in figuring out how we can evaluate AI considering we can’t just “average” all the specialist opinions. Dr. Butte points out that there still remains a massive gap in AI evaluation tools. Additionally, there are so many organizations that want to have a say in how healthcare AI is regulated that the landscape is uncertain. An awesome conversation with an expert on all things AI meets healthcare. Listen to the full episode below: Spotify: https://spoti.fi/3Wr3643 Apple: https://apple.co/4acwgan

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Bank holiday fun: This is a nice post from Graham Walker, MD describing a heuristic that can be used to expand the range of diagnoses a clinician might consider when reviewing a patient, and how it could be used as an LLM use case. Given the incredible flexibility of LLMs and the ease with which this can be tested, I've created a GPT (ChatGPT plus sub required) that allows you to try it out. https://lnkd.in/eBAWsfn5 If you do not have access to GPTs, you can find the prompt itself on github: https://lnkd.in/erdVqcFs DISCLAIMER: Do NOT use this in a clinical setting! It's just a fun demonstration of how role-based instruction prompting can deliver helpful results. I'd love to hear your feedback. #ArtificialIntelligence #DigitalHealth #GenerativeAI #GENAI #LLM #Prompting #PromptEngineering #ClinicalPromptEngineering #GPT #GPTs #ChatGPT

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Interesting report from PitchBook on first quarter Digital Health VC activity. - $1.1 billion in funding. Key late-stage deals were led by Transcarent ($126M) and Rightway ($108.8M). - The top investment categories were general & primary care ($213.4M) and health benefits navigation ($140.7M). Challenges & Trends: Valuations: Less than 20% of startups reported a priced round in the last 18 months, with an increase in extension/bridge rounds. Digital Therapeutics: Facing significant challenges due to elusive reimbursement and cautious investors. Better Therapeutics is winding down operations, and Akili is being taken private for $34M, a sharp decline from its peak valuation of nearly $450M. Telehealth: Setbacks include the shutdown of Optum's virtual care and Walmart's telehealth services. The pandemic saw over $15B in VC funding since 2020, but some platforms struggled with unsustainable business models and strategic missteps (e.g., Teladoc's costly Livongo acquisition and Amwell's delisting from Nasdaq). Looking Ahead: While digital therapeutics and telehealth face hurdles, there's potential in: Platforms integrating various treatments for conditions like diabetes, metabolic health, and mental health. Specialty telemedicine, B2B platforms, and hybrid-care models, which offer a promising investment outlook. Despite current challenges, strategic investments and a focus on sustainable models can drive the next wave of innovation in digital health. As a former digital health founder, I encourage founders in this space to keep going...there is light at the end of the tunnel! If you are a digital health founder with impressive traction based in Virginia, feel free to reach out! #digitalhealth #venturecapital #virginiaipc #virginiainvests

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At Innosphere Ventures, we’ve assessed 50+ Life Sciences startups, and we’ve noticed a trend among founders: to successfully solicit funding from investors, they need to create balance in their go-to-market strategies to be investor ready. This isn’t a surprising finding, given the majority of our founders’ status as first-time founders and academic entrepreneurs. We have amazing university partners, so the companies that they refer to us are excellent at their product and the science, they often have the foundation of a really great team, and they are on their way to a strong intellectual property strategy. But they tend to underbake the less academic parts of their investor-ready story. That’s where our Incubator comes in: to help founders balance their commercial model and story so that they’re ready to approach potential investors with an airtight business plan. With the right development, regulatory, clinical, and financial plans in hand, they’ll be able to convincingly pitch to investors how they plan to get revenue and traction, how they plan to get investors’ money back, and how they’ll generate growth… all music to investors’ ears. Our Incubator takes talented, knowledgeable founders, identifies any investor-readiness needs in their skill sets, and fills them in with critical go-to-market knowledge. That way, when they approach investors, they’ll have the full suite of product, science, and GTM know-how to successfully win funding.

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The defining factor isn't the size of the company or startup, but the vision behind it. Take OpenAI, for instance. Until last year, unless you were deeply embedded in the ML world as a computer scientist/researcher, or enthusiast, you might not have heard of OpenAI. Meanwhile, a giant like Google was dominating the scene. However, a few years back, OpenAI was just another small startup. Now, it's rapidly evolving into a major player in big tech. Why and how? It comes down to having a long-term vision, a clear roadmap, patience, and solid execution (i.e., talents). Even in the context of healthcare AI, where (small) startups face many challenges (including the ones mentioned), the principles of vision and strategy apply. While merging with big tech might seem like an option for some, if a startup truly believes in its vision and has a well-defined path to achieve it, it should forge ahead independently. The landscape is evolving, and like OpenAI, today’s small startups with clear, visionary goals could be tomorrow's industry leaders. #starup #founders #openai #google #healthcare

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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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We just released our H1 2024 Digital Health funding summary. https://lnkd.in/gAZY64tp H1 2024 Digital Health funding closed at $12.4 billion invested across 719 deals. - Q2 2024 is outperforming Q1 by 34% ($7.1 billion vs. $5.3 billion)! - Digital Health funding has shown sustained investor confidence. Funding in Digital Health in North America is up 14% to $9.5 billion. Investment in Europe is down 10% to $1.52 billion, while funding in APAC dropped by 7% to $1.17 billion. - Partnerships in Digital Health are flat in the first half at 1,730. NVIDIA has been the strongest corporate partner in H1 2024 - 96 M&As, 8 bankruptcies, 5 delistings from the stock market and 3 relistings from NASDAQ to OTC market. The full report will be available for free next week. Feel free to comment and share if you want to receive a copy prior to our official launch 😊 Galen Growth | Insights You Can Trust #funding #digitalhealth #investments #partnerships

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_What makes a good investment in healthcare? _ When is a good time to start thinking about the path to exit? _Where do we see the next #unicorn in #systemichealth? Experienced healthcare investor Dai Feng from CareCapital Group joins me and Jonathan Levine for our very first *video* episode of the #ThinkOralHealth #podcast. Take a listen.

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Harnessing Proprietary Information for Strategic Healthcare Investments Healthcare investments offer a unique combination of financial returns and the potential for significant social impact. For family offices and discerning investors, navigating this complex landscape requires more than just capital—it demands strategic insights fueled by proprietary information. The Foundation of Strategic Investment: Proprietary Information In the investment world, knowledge is power. This is particularly true in the healthcare sector, where regulatory landscapes, technological advancements, and policy changes can drastically impact the viability and potential of investment opportunities. Access to proprietary information gives investors a critical edge, enabling them to: - Anticipate Market Movements: With insights into healthcare policies and emerging trends, investors can position their portfolios to capitalize on upcoming shifts in the market. - Enhance Due Diligence: Tailored underwriting and due diligence tools grounded in exclusive data can highlight risks and reveal hidden potentials in investment prospects. - Maximize Value Creation: By understanding the intricacies of the US healthcare economy, investors can devise strategies for long-term value creation, rather than short-term gains. Empowering Family Offices Family offices often seek investments that offer both competitive financial returns and the opportunity to create a positive legacy. By refining investment platforms to address the specific needs of these entities, such as instant diversification and upside capture, they can achieve their financial and legacy-driven goals. These platforms can provide: - Market Insights: Curated intelligence that focuses on the most promising healthcare segments. - Educational Resources: In-depth content to deepen the understanding of healthcare technology trends and investment strategies. Building Relationships and Trust Investing is not just about the numbers; it's also about people. To attract and retain high-potential family office prospects, investment platforms must foster empathy and engagement. This involves: - Offering Exclusive Rights: Providing access to follow-on deals and direct investment opportunities with board or advisory roles. - Understanding Emotions: Addressing fears of missing out on prime opportunities due to geographical limitations and dissatisfaction with average investment options. - Creating Community: Facilitating a network of like-minded investors focused on collaborative, high-impact healthcare investments. Harnessing proprietary information is critical for making strategic healthcare investments that offer significant financial returns and contribute to the betterment of society. If you like to learn more about strategic healthcare investments or discuss your specific investment goals and how proprietary information can be leveraged to achieve them? Please feel free to reach out or leave a comment below.

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Here’s your recap of last week’s health IT news 🗞️ 👇 🤖 AI Products • Emergency Services, Inc. + Augmedix Go ED: The emergency medicine group adopted the new ED-specific AI ambient scribe solution.    • Color + OpenAI: The cancer care tech company partnered with the GenAI giant to build a AI clinical decision support copilot.    • AKASA Medical Coding: The AI RCM vendor known for its AI prior auth tool AKASA Authorization Advisor released a new GenAI medical coding solution.    • Humata Health: The AI prior auth for providers vendor closed a $25M funding round led by healthcare org-backed funds The Blue Venture Fund and LRVHealth.    • Wellsheet + Concord Hospital Health System: The AI-enabled Smart EHR UI solution announced a client-reported 16.3% reduction in length of stay and 40% decrease in time spent in the EHR via its partnership with Concord Health, as well as the release of its new LLM-generated handoff summary feature. 🍎 VBC • BSIM Healthcare Services + Innovaccer: The healthcare provider—embarking on its first VBC contract—adopted the pop health data platform for analytics. 🩼 Durable Medical Equipment • Parachute Health: The DME e-prescribing and ordering solution released an update that integrates prior authorization. ⚕️Clinical Staffing • Matchwell + Indiana Hospital Association: The clinical staffing service partnered with the hospital member org to create the first state-wide resource pool for temp staffing. 🧑‍💻 Virtual and At-Home Care • Deaconess Health System + KeyCare: The Indiana-based health system adopted the Epic-based virtual care provider for around-the-clock virtual urgent care.    • UC Davis Health + Current Health: The health system launched a new RPM program for high blood pressure in partnership with Best Buy Health’s care-at-home platform. 🧠 Food for Thought: We came across a couple of good resources this past week on the current state of healthcare data information exchange: • This article in Health Affairs from Deven McGraw and Tina Grande provides a comprehensive overview of some of the patient health data abuses we've seen come to light in recent months, as well as a number of policy recommendations to improve the health information exchange landscape for all participants. https://lnkd.in/e_GEQ-JJ  (h/t Alya Sulaiman)    • This episode of Health Gorilla's InteropTalk gives a helpful update on the current state of affairs, with a particular focus on the state of trust across the health data exchange community and how the definition of "Treatment" may evolve. https://lnkd.in/e96AJG-5 (h/t Brendan Keeler) --- Reminder: you can sign up for the Elion Briefing to get the latest healthcare tech news delivered to your inbox each week 📬 👉 https://lnkd.in/e2UJ3ckP

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The obesity crisis in the U.S. has become unsustainable. We are broken, and we have to change... The prevalence of obesity in adults has grown from 14.5% in 1975 to 41.9% in 2020, and childhood obesity has more than TRIPPLED since the 1970s. The total annual cost of obesity is at a staggering $1.4 trillion. Treatment options range but the emergence of GLP-1's has taken on a national debate. It is our view at 7wireVentures that the growing obesity crisis requires innovative and personalized solutions and digital health companies are rising to meet this challenge. Our team took a deep dive into the market landscape and came up with key predictions on how the market will evolve. ✨ PREDICTION 1: The emergence of high-cost anti-obesity medications and their growing consumer demand will push employers and payers to seek increasingly creative plan design structures that tackle weight management as a discrete disease category.​ 💉 PREDICTION 2: Greater emphasis will be placed on proactive identification and management of patients with an obesity diagnosis 🔬 PREDICTION 3: Key differentiators of successful solutions will include long-term engagement and the ability to address multiple chronic conditions. 🤝 Innovative companies such as 9amHealth, Parsley Health, Transcarent, Everly Health, Foodsmart, Livongo, Season Health, Iron Health, Cylinder, and more. See our full analysis and perspectives on enabling positive change in weight management. 👇 #digitalhealth #obesity #GLP1 #disease #healthcare https://lnkd.in/gUCttSZj

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"In H1 2024, U.S. digital health startups raised $5.7B across 266 deals🤑. If investment patterns continue, 2024 could exceed 2019 and 2023 year-end totals ($8.2B and $10.7B, respectively)." - sounds promising and inspiring, doesn't it? [Link to report in comments👇] As our company builds customer software solutions for various industries, including HealthTech🏥, I've been diving deep into recent reports. And I've compiled a list of some insightful HealthTech reports and resources!📈 Just drop a comment with "HealthTech"✍ and I'll send this list of useful resources to you📩 #healthtech #startup #startups #healthtechindustry #digitalhealth #healthtechsoftware #healthtechstartups

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Healthtech regulations are essential, especially with the rapid deployment of medical AI. Ensuring safety must be the top priority. Therefore, a Digital Health Act is needed to strengthen the capabilities of national FDAs to guarantee safety and effectiveness. #health #medicalai #fda

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One of my proudest moments as an investor occurred today as Alaffia Health announced its series A because it shows how the Aperture® Venture Capital vision of multi-level, multi-generational #impactinvesting is succeeding in the marketplace. Here’s the model in its most basic form : ✅As diverse fund managers with meaningful capital to allocate, we are changing the VC landscape every day just by doing our day jobs. ✅As Black/Brown investors with ~40 years experience collectively, Aperture GPs have access to talent /excellence that others do not, so our portfolio *organically* is more inclusive by race, gender and geography even while optimizing for financial outcomes (all about the alpha). ✅Our most successful portco’s are using financial #innovation to solve market problems that impact underrepresented demographics and underserved communities. Alaffia Health is a shining example of the impact portion of our overall fund thesis, and we couldn’t be prouder of TJ Ademiluyi and Adun Akanni, MPH, PMP - the dynamic brother-sister founder duo whose vision we have steadfastly supported on their journey. Congratulations to TJ and Adun from William Crowder and myself, as well as the whole Aperture team- Marjorie King Philip McKenzie Yves Louis-Jacques Tanvi Lal Michelle Dhansinghani Lisha Bell Katie Kelly Amy Chung Cindy Chong, CFA Brian Fernandes-Halloran Monroe France Jayden Pantel Darren Herman Evan Wladis Neal Triplett Thomas Scriven Peter Ammon Irina Bit-Babik Tim Milanich Rob Rahbari

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Why Physicians Should Consider Investing in HealthTech Venture Funds As a physician deeply entrenched in the world of healthcare, I've observed firsthand the transformative impact of technology on our industry. From telemedicine to AI-driven diagnostics, the pace of innovation is staggering—and it’s only accelerating. Today, I want to share why we, as physicians, should consider investing in HealthTech venture funds 👇 - Driving Innovation: By investing in HealthTech funds, we're not just placing capital; we're actively propelling the future of medicine. Our investment helps fund the technologies that could one day revolutionize patient care and our daily medical practices. - Insider Expertise: Who better to understand the potential of a new medical technology than those of us in the field? Our clinical experience enables us to assess the feasibility and potential impact of innovations, making us well-suited to make informed investment decisions. - Spreading Impact Beyond Practice: While we impact lives daily through direct patient care, investing in a HealthTech fund allows us to extend our influence by supporting solutions that reach a global patient base, potentially benefiting millions. - Financial Returns: HealthTech is one of the fastest-growing sectors, and investing in this area offers a valuable opportunity for substantial financial returns. Diversifying our portfolios beyond traditional stocks and real estate into venture funds can offer a unique balance of risk and reward. - Personal and Professional Growth: Engaging with the startup and tech ecosystem exposes us to new ideas and business strategies, broadening our horizons beyond clinical practice. This can lead to professional growth and networking opportunities that may not otherwise arise. I encourage my fellow healthcare professionals to look into HealthTech venture funds as a way to participate in the broader spectrum of healthcare innovation. Our expertise and capital can play a crucial role in shaping the future of the industry. ---- To join our vibrant community of 2,000+ healthtech experts and thought leaders, click the link in my profile bio.

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