digital health
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Our favorite startups from YC’s Summer 21 Demo Day, Part 1
Y Combinator kicked off its fourth-ever virtual Demo Day today, revealing the first half of its nearly 400-company batch. The presentation, YC’s biggest yet, offers a snapshot into where innovation is heading, from not-so-simple seaweed to a Clearco for creators.
The TechCrunch team stuck to its tradition of covering every single company live (but, you know, from home) so you’ll find all of the Day One companies here. For those who want a sampling of standouts, however, we’re also bringing you a host of our favorites from today’s one-minute pitch-off extravaganza.
As reporters, we’re constantly inundated with hundreds of pitches on a daily basis. The startups below caught our picky attention for a whole host of reasons, but that doesn’t mean other startups weren’t compelling or potential unicorns as well. Instead, consider the below to be a data point on which startups made us do a double take, be it due to the size of the market opportunity, the ambition exhibited by the founding team or an idea that was just too clever to pass up.
Genei
Genei is, dare I say, a refreshing mashup between robots and writers. The startup has a simple goal: Automatically summarize background reading so content creators can grab the top facts, attribute and move onto the next graf. Writing is innately an art, so I find Genei’s positioning as a tool for writers instead of a replacement out to take their jobs as smart. Better yet, it’s launching by targeting some of the hardest workers in our industry: freelance writers. These folks often have to balance consistent pitches, diverse assignments and tight deadlines for their livelihood, so I’d presume a sidekick can’t hurt. Down the road, I could totally see this startup playing the same role as a Grammarly: a helpful extension of workflows that optimizes the way people who write for a living, write. — Natasha
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Musculoskeletal medical startups race to enter personalized health tech market
As the pandemic unevenly roars on, Emily Melton, founder and managing partner of Threshold VC, is reflecting on a previous public health crisis: the Spanish flu.
She says the response just over a century ago prompted the rise of interventional medicine — treating illness through surgery or medicine only after symptoms manifest. Today, interventional medicine is the dominant mindset in Western healthcare. And, Melton, a lead investor in health tech startups including Livongo, Tia and Calibrate, says the care pathway ages well.
Personalized medicine — the buzzy yet powerful framing growing in popularity among Silicon Valley startups — is a delivery system in which patients receive more holistic care that takes into account multiple symptoms or comorbidities.
“What’s happening in our society? Chronic diseases, chronic pain, diabetes and obesity,” she said. “That doesn’t require a magic pill and there’s not just a surgery. Oftentimes, there’s therapeutic components, behavior changes and movable touch points.”
Enter personalized medicine. The buzzy yet powerful framing is growing in popularity among Silicon Valley startups. It’s a delivery system in which patients receive more holistic care that takes into account multiple symptoms or comorbidities. In hormonal health, for example, personalized medicine could add more data and specificity to which birth control someone takes, instead of the usual process of trial and error. Essentially, it’s the opposite of interventional medicine.
“We’re not just an arm or a leg, we’re not just obese or a diabetic or a pain sufferer,” Melton said. “How do we treat you as a whole person?”
A number of companies are using this approach to reinvent care for patients with musculoskeletal (MSK) medical conditions and chronic pain. These conditions are commonly treated with addictive opioids, a major public health concern. As an estimated 50 million Americans suffer from chronic pain, entrepreneurs are working on solutions that don’t resemble the cookie-cutter status quo. And the money market is certainly there: In 2017, the global MSK medical market was valued at $57.4 billion; the market for chronic pain, which overlaps with MSK medicine, is expected to hit $151.7 billion in value by 2030.
“Oftentimes it’s not new ideas, it’s conflating a number of factors that come together at one moment in time that allow exponential change that makes a startup work,” Melton said, of the boom and recent activity in MSK medicine. Today, we’ll focus on three startups taking different approaches to help people suffering from chronic pain and MSK-related conditions: Clearing, PeerWell and Hinge Health.
Clearing
Avi Dorfman says going direct to consumers is the most effective way to treat chronic pain, so he founded Clearing. The digital health startup worked with a medical advisory board of physicians and researchers from Harvard, Johns Hopkins and NYC’s Hospital for Special Surgery to create an opioid-free solution for people struggling with pain.
Last month, Clearing raised a $20 million seed round led by Bessemer and Founders Fund. Melton also invested in the round on behalf of Threshold.
Clearing offers four products: prescription compound cream that includes FDA-approved ingredients, CBD cream for topical discomfort, nutraceuticals to supplement joint health, and a directory of prerecorded, at-home exercises. It currently is available to patients in California, Florida, Georgia, Illinois, New York, North Carolina, Ohio, Pennsylvania, Tennessee and Texas.
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Five success factors for behavioral health startups
Courtney Chow is an associate with Battery Ventures in San Francisco who focuses on early and growth-stage internet, software and services companies.
Justin Da Rosa
Contributor
Contributor
Justin Da Rosa is a vice president with Battery Ventures in San Francisco. He focuses on consumer internet, online marketplace and software investments.
Telehealth, or remote, tech-enabled healthcare, has existed for years in primary medical care through companies like Teladoc (NYSE: TDOC), Doctors on Demand and MDLIVE.
In recent years, the application of telehealth had rapidly expanded to address specific chronic and behavioral health issues like mental health, weight loss and nutrition, addiction, diabetes and hypertension, etc. These are real and oftentimes very severe issues faced by people all over the world, yet until now have seen little to no use of technology in providing care.
We believe behavioral health is particularly suited to benefit from the digitization trends COVID-19 has accelerated. Previously, we’ve written about the pandemic’s impact on online learning and education, both for K-12 students and adult learners. But behavioral health is another area impacted by the fundamental change in consumers’ behavior today. Below are four reasons we think the time is now for behavioral health startups — followed by five key factors we think characterize successful companies in this area.
Telehealth can significantly lower the cost of care
Traditional behavioral healthcare is cost-prohibitive for most people. In-person therapy costs $100+ per session in the U.S., and many mental health and substance-use providers don’t accept insurance because they don’t get paid enough by insurers.
By contrast, telehealth reduces overhead costs and scales more effectively. Leveraging technology, providers can treat more patients in less time with almost zero marginal costs. Mobile-based communications enable asynchronous care that further helps providers scale. Access to digital content gives patients on-going support without the need for a human on the other side. This is particularly useful in treating behavioral health issues where ongoing support and motivation may be necessary.
Technology unlocks supply in “shadow markets” of providers
Globally, we face an extreme shortage of behavioral health providers. For example, the United States has fewer than 30,000 licensed psychiatrists (translating to <1 for every 10,000 people). Outside of big cities, the problem gets worse: ~50-60% of nonmetro counties have no psychologists or psychiatrists at all.
Even when providers are available, wait times for appointments are notoriously long. This is a huge issue when behavioral health conditions often require timely intervention.
We are seeing new platforms build large networks of certified coaches, licensed psychologists and psychiatrists, and other providers, aggregating supply in what has historically been a scarce and a highly fragmented provider population.
Behavioral/mental health issues are losing their stigma
We believe the stigma associated with mental illness and other behavioral health conditions is dissipating. More and more public figures are speaking out about their struggle with anxiety, depression, addiction and other behavioral health issues. Our zeitgeist is shifting fast, and there’s an all-time high in people seeking help as the Google Trends data below demonstrates.
Image Credits: Google
Note: The anomalous dip in March/April ’20 was driven by mandatory shelter-in-place due to COVID-19.
Policy and regulations are changing quickly
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Health APIs usher in the patient revolution we have been waiting for
Rish Joshi
Contributor
Contributor
Rish is an entrepreneur and investor. Previously, he was a VC at Gradient Ventures (Google’s AI fund), co-founded a fintech startup building an analytics platform for SEC filings and worked on deep-learning research as a graduate student in computer science at MIT.
If you’ve ever been stuck using a health provider’s clunky online patient portal or had to make multiple calls to transfer medical records, you know how difficult it is to access your health data.
In an era when control over personal data is more important than ever before, the healthcare industry has notably lagged behind — but that’s about to change. This past month, the U.S. Department of Health and Human Services (HHS) published two final rules around patient data access and interoperability that will require providers and payers to create APIs that can be used by third-party applications to let patients access their health data.
This means you will soon have consumer apps that will plug into your clinic’s health records and make them viewable to you on your smartphone.
Critics of the new rulings have voiced privacy concerns over patient health data leaving internal electronic health record (EHR) systems and being surfaced to the front lines of smartphone apps. Vendors such as Epic and many health providers have publicly opposed the HHS rulings, while others, such as Cerner, have been supportive.
While that debate has been heated, the new HHS rulings represent a final decision that follows initial rules proposed a year ago. It’s a multi-year win for advocates of greater data access and control by patients.
The scope of what this could lead to — more control over your health records, and apps on top of it — is immense. Apple has been making progress with its Health Records app for some time now, and other technology companies, including Microsoft and Amazon, have undertaken healthcare initiatives with both new apps and cloud services.
It’s not just big tech that is getting in on the action: startups are emerging as well, such as Commure and Particle Health, which help developers work with patient health data. The unlocking of patient health data could be as influential as the unlocking of banking data by Plaid, which powered the growth of multiple fintech startups, including Robinhood, Venmo and Betterment.
What’s clear is that the HHS rulings are here to stay. In fact, many of the provisions require providers and payers to provide partial data access within the next 6-12 months. With this new market opening up, though, it’s time for more health entrepreneurs to take a deeper look at what patient data may offer in terms of clinical and consumer innovation.
The incredible complexity of today’s patient data systems
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Where top VCs are investing in digital health
The world of healthcare has notoriously been described as “broken” — plagued with high-friction workflows, sky-high costs and convoluted business models.
Over the past several years, a long list of innovative startups and salivating venture investors have pinned their focus on repairing the healthcare industry, but its digital transformation still appears to be in the very early innings. After a record-setting 2018, however, digital health investing continued to reach meteoric heights in 2019.
Mammoth pools of capital have flooded into various sub-verticals and business models, backing collections of new B2B and B2C companies focused on optimizing healthcare workflows, improving healthcare access and offering lower-cost distribution models. Over the past two years, digital health startups have raised well over $10 billion in funding across nearly 1,000 deals, according to data from Pitchbook and Crunchbase.
As we close out another strong year for innovation and venture investing in the sector, we asked nine leading VCs who work at firms spanning early to growth stages to share what’s exciting them most and where they see opportunity in the sector:
- Annie Case, Kleiner Perkins
- Zavain Dar, Lux Capital
- Adam Goulburn, Lux Capital
- Kristin Baker Spohn, CRV
- Raju Rishi, RRE Ventures
- Olivia Lew, General Catalyst
- Bill Liao, SOSV
- Jennifer Hartt, Ben Franklin Technology Partners
- John Prendergass, Ben Franklin Technology Partners
Participants discuss trends in digital therapeutics, telehealth, mental health and the latest in biotech and medical devices, while also diving into startups improving medical practitioner efficiency, evaluating the evolving regulatory environment and debating valuations and offering a ‘temp check’ on the market for digital health startups leveraging ML.
Annie Case, Kleiner Perkins
Although Kleiner Perkins has a long history of investing in iconic health companies, we believe it is still the early innings of digital health as a category today.
When I evaluate new opportunities in the space, I often start by thinking through how the company will move the needle on cost, quality, and access to care — the “iron triangle” of health care systems. Conventional wisdom has been that it’s impossible to improve all three dimensions simultaneously, but we are seeing companies leverage technology to shift this paradigm in meaningful ways.
It’s no longer just a promise. For example, Viz.ai is using artificial intelligence to detect and alert stroke teams to suspected large vessel occlusion strokes, enabling patients to get treatment faster. Their workflows improve access to life-saving care, deliver higher quality through reduced time to treatment (every minute counts as ‘time is brain’ in stroke care), and dramatically reduce the costs associated with long-term disability.
We are also seeing companies provide this type of tech-enabled care outside of the hospital setting. Modern Health is a mental health benefits platform that employers are making available to their employees. The platform triages individual employees to the right level of care, providing clinical care to those with diagnosable depression or anxiety, and making self-guided or preventative care available to everyone else. Their solution improves quality and access by offering mental health services to every employee and reduces the cost associated with untreated mental illness, lost productivity, or employee churn.
Heading into 2020, we’re eager to back digital health companies in new areas that leverage technology to impact cost, quality, and access. A few spaces that I’m excited about are behavioral health (mental health, substance abuse, addiction, etc), care navigation, digital therapeutics, and new models integrating telehealth, remote care and AI to better leverage medical professionals’ time.
Zavain Dar and Adam Goulburn, Lux Capital
Below are some thoughts and coming predictions on health tech broadly:
- Digital therapeutics continue to pick up steam — on the back of Pear and Akili, more companies push to FDA and enter the market. In addition, broader consumer platforms like Calm and Headspace look to broaden their offerings by investigating clinical approvals.
- At least one major pharma looks to expand its consumer surface area by acquiring one of the new digital, consumer-facing generics platform (ex Hims, Ro, NuRx).
- Venture funding for biotech continues to boom with at least three Series A’s of $100M or more in size.
- Drug discovery for neurodegeneration sees a renaissance. High-profile failings of Biogen and the beta-amyloid hypothesis sees a shift of innovation to early-stage biotech and venture creation.
- Big pharma has its DeepMind moment acquiring at least one machine-learning (AI) enabled drug discovery company.
- Clinical trial tech investments heat up; new companies and technologies emerge to make trials patients first and systems get smarter at finding the right patients at their point of care; large incumbents like IQVIA, LabCorp and PPD get acquisitive.
- At least three traditional Sand Hill Road tech venture firms open life science practices or raise dedicated funds.
- Machine learning targets chemistry driven by large advancements in transformer (NLP) models; has the time for computational chemistry finally come?
- HCIT sees a renaissance driven by increased CIO responsibility towards data interoperability. Companies either working on federated ML to allow systems to speak to each other or lightweight edge applications enabling rapid clinical deployment will see quick uptake and traction, until now impossible in HC.
Kristin Baker Spohn, CRV
In the last 10 years, digital health has exploded. Over $16B has been invested in the sector by VCs and we’ve seen IPOs from Livongo, Progyny and Health Catalyst, just in the last year alone. That said, there’s still a lot that mystifies people about the sector — there are spots that are overheated and models that will struggle to deliver venture scale outcomes. I’ve seen digital health evolve first hand as both an operator and investor, and I’m more excited than ever about the future of the space.
A few areas and trends that I’ve been following recently include:
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European early-stage VC firm ‘Project A’ on Europe’s startup scene taking the next step
Project A, the Berlin-based VC, just raised a new $200 million fund (€180 million) to continue backing European startups at Seed and Series A stage.
In addition, the firm — whose investments include WorldRemit, Catawiki, Voi and Uberall — announced it will now have a presence in London and Stockholm in order to put people on the ground in what it says are “two of its favorite ecosystems.”
What better time, therefore, to catch up with the team at Project A, where we talked investment thesis, why Stockholm and London, and the increasing interest in Europe from U.S. LPs and VCs. Other subjects we touched on include diversity in venture, and, of course, Brexit!
TechCrunch: You last raised a fund in 2016, totaling €140 million, what changes have you noticed since then with regards to the types of companies you are seeing and the European ecosystem as a whole?
Uwe Horstmann: Entrepreneurs definitely matured a lot over the last few years. We see more and more of serial founders who combine drive with experience delivering great results. We also noticed an increase in more tech / product-centric and in B2B models.
This doesn’t come as a surprise as the market for consumer-oriented models started developing much earlier and is now reaching its limits after a few years. Many entrepreneurs gained experience in the Old Economy or have been consulting companies for a few years, learned about the struggle with products and processes first-hand and developed solutions specifically tailored to the industry’s needs.
We also notice a rise in professionalism in company setups and a higher ambition level in founding teams. This is probably also due to a more professional angel and micro fund scene that has developed in Europe.
TC: I note that you have U.S. LPs in the new fund, which I think is a first for Project A, and more broadly we are seeing a lot more interest from U.S. VCs in Europe these days. Why do you think that is, and how does this change the competitive landscape for deal-flow and the ambition of European founders?
Thies Sander: Having our first U.S. LPs on board makes us proud. LPs have noticed that European VC returns have really picked up during recent fund cohorts.
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Kelvin Kwong leaves Jawbone for product VP role at Big Health
As Jawbone continues to work towards a pivot, the Up device maker also continues to talent that may not be core to its future. In the latest departure, Kelvin Kwong, who had been the Jawbone’s director of product management, has joined Big Health, maker of the Sleepio sleep improvement program, as VP of product management. Alongside that, Dr Jenna Carl is now the startup’s… Read More
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