Health
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Time is critical for healthcare providers, especially in the middle of the pandemic. Singapore-based Bot MD helps save time with an AI-based chatbot that lets doctors look up important information from their smartphones, instead of needing to call a hospital operator or access its intranet. The startup announced today it has raised a $5 million Series A led by Monk’s Hill Venture.
Other backers include SeaX, XA Network and SG Innovate, and angel investors Yoh-Chie Lu, Jean-Luc Butel and Steve Blank. Bot MD was also part of Y Combinator’s summer 2018 batch.
The funding will be used to expand in the Asia-Pacific region, including Indonesia, the Philippines, Malaysia and Indonesia, and to add new features in response to demand from hospitals and healthcare organizations during COVID-19. Bot MD’s AI assistant currently supports English, with plans to release Bahasa Indonesian and Spanish later this year. It is currently used by about 13,000 doctors at organizations including Changi General Hospital, National University Health System, National University Cancer Institute of Singapore, Tan Tock Seng Hospital, Singapore General Hospital, Parkway Radiology and the National Kidney Transplant Institute.
Co-founder and chief executive officer Dorothea Koh told TechCrunch that Bot MD integrates hospital information usually stored in multiple systems and makes it easier to access.
Image Credits: Bot MDWithout Bot MD, doctors may need to dial a hospital operator to find which staffers are on call and get their contact information. If they want drug information, that means another call to the pharmacy. If they need to see updated guidelines and clinical protocols, that often entails finding a computer that is connected to the hospital’s intranet.
“A lot of what Bot MD does is to integrate the content that they need into a single interface that is searchable 24/7,” said Koh.
For example, during COVID-19, Bot MD introduced a new feature that takes healthcare providers to a form pre-filled with their information when they type “record temperature” into the chatbot. Many were accessing their organization’s intranet twice a day to log their temperature and Koh said being able to use the form through Bot MD has significantly improved compliance.
The time it takes to onboard Bot MD varies depending on the information systems and amount of content it needs to integrate, but Koh said its proprietary natural language processing chat engine makes training its AI relatively quick. For example, Changi General Hospital, a recent client, was onboarded in less than 10 days.
Bot MD plans to add new clinical apps to its platform, including ones for electronic medical records (EMR), billing and scheduling integrations, clinical alerts and chronic disease monitoring.
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Nathalie Walton almost didn’t become a mother. Her risky pregnancy caused her placenta to burst during childbirth, almost killing her and her son last year. Walton, who feels lucky to have survived, says the haunting experience made her an example of a reality she had long known: To be a pregnant Black woman is to be at risk, regardless of economic background.
The stress of her pregnancy led Walton to download Expectful, a meditation and sleep app for new mothers. She recalls stabilizing, emotionally and physically, within a week, bringing an otherwise “soft landing” to a volatile pregnancy.
Weeks after delivering her son, Everett, Walton just so happened to hear of an advisory role opening at Expectful. Even though she was mid-maternity leave from her managerial role at Airbnb, she jumped at the opportunity.
“I definitely had a full-time job, I had a newborn baby,” Walton said. But, she says, it was an opportunity to be entrepreneurial in a sector she cared about. Even if it was just for a few months.
And now, Walton is the chief executive of the company. The business is pivoting its product strategy to grow beyond recorded meditations. Walton helped it raise its first millions in venture capital, making her one of the few dozen Black female founders to do so. New financing and the boom of the mental health focus amid the coronavirus pandemic puts Expectful in a coveted spot. And it puts Walton, who is at the helm of a company for the first time, in a pressure-cooker spotlight.
Even in the world of startups, going from user to chief executive in less than a year is a remarkable feat. But it’s not one that she rushed.
Walton graduated from Georgetown and immediately joined the New York banking world. After a few years as an analyst at JP Morgan, though, she became unsatisfied with the work.
“I think I had a quarter-life crisis,” Walton said. Searching for new opportunities, she ended up at a prospective students day at Stanford University in what would become a pivotal moment in her life.
“For the first time, I met entrepreneurs and saw an actual concept that you can pursue a career you like, be successful and make a difference in the world,” she said. Walton eventually applied, and got accepted, to Stanford Graduate School of Business (GSB), a prestigious program that produces founders and top executives. It was then that she realized she wanted to be a chief executive one day.
“I admired them, but I just didn’t see the pathway for me to get there,” she said, of the entrepreneurs she met, who were then largely white and male. “I didn’t have the confidence.”
So, she set that hope aside and pursued intrapreneurship, which would let her join a stable organization and act as a mini-founder within it. Employees in this role are tasked with building a startup within a startup, whether that is rooting an innovative idea or leading an experiential team. Corporations have long embraced this idea to bring momentum to otherwise red-tapey processes.
Walton joined eBay and soon rose to work as the head of business operations and development. Her work helped the company break into 3D printing.
Over the years, this has been the defining characteristic of Walton: join an organization, build a scrappy idea from scratch, and then do it all over again. She has held roles in Airbnb and Google that all required her to have the agility of a founder convincing people on a moonshot vision, and the rigor of a manager who can get a deal done.
She had the same vision heading into an advisory role at Expectful. But when Walton landed a key Expectful partnership with Johnson & Johnson, then-CEO and founder Mark Krassner had an idea.
Before starting Expectful, Krassner experienced the benefits of meditation firsthand. He also saw his mother face depression, which made him realize how meditation could have a positive impact on others. After seeing research that showed how meditation could positively impact a pregnancy, he began thinking of a solution in this cross-section. He eventually started a course on Teachable, a startup that lets anyone create and monetize an online class, with 15 moms and a guided meditation.
Over time, the idea stuck. Krassner eventually turned his course into a 12-person startup. Under his leadership, Expectful grew to profitability and over 13,000 paid users. Its conversion rate from free to paid users was five times higher than industry standards, the company claims.
That said, from the moment Mark Krassner started Expectful, he knew he was an unlikely founder. He doesn’t have any children, so leading a meditation and sleep app for new mothers comes with its own hurdles.
“As a male founder with no kids, it was on my mind from day No. 1,” Krassner said. He eventually wanted to put a female at the head of the company, he says. Walton was the obvious choice.
Walton returned to Airbnb after her maternity leave right as Airbnb had aggressive COVID-19 layoffs. While her job was saved, her team disappeared as part of the cuts. She started looking for jobs, and received lucrative offers from Facebook, Apple, Google and Amazon. When she told Krassner she was leaning toward a lead product manager position at Amazon, he replied with an offer to take over Expectful’s entire business.
“I think it caught her off guard,” Krassner said, who is still a board member at the company. “Usually you don’t think a CEO is looking for [a new CEO] unless things are going to hell in a handbasket.”
Expectful began as a guided meditation library, which will continue to be its core. But now, Walton wants to take advantage of that momentum and evolve the company into a “go-to wellness resource for hopeful, expecting and new parents.”
The language suggests that the startup is evolving in how it markets itself. Right now, the site has a number of references to “motherhood” and women. But Walton says Expectful defines a mother by anyone who identifies themselves as one. While the startup primarily has content geared toward the gestational parent, or the one who gives birth to the child, Walton says they have a “a partner’s library for non-gestational parents that identify as non-gestational mothers, fathers, or however they choose to identify.”
Walton plans to pivot the startup in three phases: content, marketplace and community.
For content, Expectful wants to organize pregnancy-related information. Currently, a lot of information or advice around pregnancy lives in books or in-person classes. But the learning experience, which Walton says is similar to middle school-style lectures, doesn’t feel built for this century.
The next step in her plan is digitizing the service providers that help women through pregnancy. In simpler words, replace the disorganized recommendations in Facebook groups for parents.
“When I went to ask my OB-GYN for recommendations for a doula, she gave me a sheet of paper with the names of 10 doulas,” she said. “You have to text the doula, ask them questions and if they want to meet up — it all feels yucky.” Expectful wants to put all that information in one platform so moms can access tips and recommendations from the ease of their homes.
The end-product here would be a peer-reviewed platform that can help a mom find everything from a therapist to a live-in nanny, with reviews built-in.
Finally, Walton wants to invest in the community. Expectful recently launched Mother Circles, which connects postpartum mothers into support cohorts led by a doula facilitator. The circles include six weekly video calls, a group chat and 500 hours of on-demand doula support.
Image Credits: Expectful
Part of Walton’s focus through all of these priorities is to invest in Black maternal health outcomes. Her own experience, she says, showed her how even a “Stanford-educated wellness junkie” such as herself can be at a high-risk for pregnancy because of her skin color.
It’s a lofty goal, even with the promising growth and strong library of guided meditations. The competition is steep. One of Expectful’s closest competitors is Peanut, a social network for moms used by over 1.2 million people. Mahmee, a digital support network for postpartum mothers, has raised $3 million and views itself as complementary to Expectful. Headspace has launched its own motherhood meditation series, but it is not as comprehensive as Expectful’s.
“I think we’re able to connect with women in a way that some of these other companies aren’t,” Walton said. “People are paying for the service, so they clearly need it.”
While Walton declined to share new user metrics, she said that the company’s revenue has grown 100% since March 2020.
Long-term, Expectful wants to mimic Peloton’s playbook in terms of getting premium content and community to the right audience. Still, growing from a startup to a venture business requires more than just ambition and market fit. It requires the ability to exponentially grow and keep growing.
A handful of investors believe that Walton’s Expectful can do it. Expectful raised $3 million in a seed financing round led by Harlem Capital. Indicator Ventures, Sequoia Scout Fund, Joyance Partners, Break Trail Ventures, Chinagona Ventures, Powerhouse Capital, AVG Basecamp Fund and Babylist also participated. Angel investors included Ellen Pao, Mike Smith and Ashley Mayer. The round also included $1.2 million in convertible SAFE notes, making the financing round a total of $4.2 million.
“Historically when I look at what black women raise fundraising, I feel fortunate that I’ve been able to raise this round,” Walton said.
Harlem Capital founding partner Henri Pierre-Jacques said that “obviously, given our focus we weren’t going to invest in a white male.” Walton’s “founder-market fit” is what made the firm invest, even with the hairy dynamic of an exiting CEO.
Mayer, head of communications at Glossier, was the one who introduced Walton to the woman who told her about the advisory role of Expectful. She says that Nathalie’s “path to entrepreneurship feels inevitable.
“It was always just a question of finding the space where her passions collided,” Mayer said.
As a new mother and new founder, Walton has had a busy balancing act of a year.
“I’m working more now than I have really in the last decade,” she said. “But I’ve never been more fulfilled because, as someone who went through this, and I’m still going through this, I feel so personally the level of pain that so many women suffer through.”
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Sano Genetics, a startup with a broad mission to support personalised medicine research by increasing participation in clinical trials, has raised £2.5 million in seed funding.
The round is led by Episode1 Ventures, alongside Seedcamp, Cambridge Enterprise, January Ventures and several Europe and U.S.-based angel investors. It adds to £500,000 in pre-seed funding from 2018.
Sano Genetics says part of the new capital will be to fund free at-home DNA testing kits for 3,000 people affected by Long COVID. It will also further invest in the development of its tech platform and grow the team.
Founded in 2017 by Charlotte Guzzo, Patrick Short and William Jones after they met at Cambridge University while studying genomics as postgrads, Sano Genetics has built what it describes as a “private-by-design” tech platform to help patients take part in medical research and clinical trials. This includes at-home genetic testing capabilities, and is seeing the company support research into multiple sclerosis, ankylosing spondylitis, NAFLD and ulcerative colitis2, with a research programme for Parkinson’s disease on the agenda for later in 2021.
“For participants in medical research, the process is not user friendly,” says Sano Genetics CEO Patrick Short. “There is usually little to no benefit for participants beyond altruism, taking part is difficult and time-consuming and people are also concerned about the privacy of their sensitive genetic and medical information.
“[Therefore], for researchers in biotech, pharma and academia, it is very difficult to attract and retain research participants, which adds substantial costs and time to their research. In particular for research involving genetics and precision therapies, it is doubly challenging to find the ‘right’ patients because genetic testing is not routine in the healthcare system”.
To help solve this, Sano Genetics matches relevant participants to research via its platform. It then makes participation easier by enabling at-home genetic testing and by guiding participants through the process.
“The system is designed so users know exactly what will happen with their data, and we give them straightforward ways to control their data,” explains Short. “We keep our users engaged and involved in the research process by giving them updates on the research they have been a part of, and with free personalised content including genetic reports, and stories from other people like them on our blog”.
A typical end user is someone who has a chronic or rare disease and is using the platform to take part in research that helps them personally (e.g. access to a new therapy via a clinical trial) or to help others like them.
Meanwhile, Sano Genetics generates revenue by charging biotech and pharma companies fees to find the right patients for their studies. “The typical study for us consists of a set-up fee, a per-test fee for our at-home genetic testing and analysis, and a fee for each referral we make of an interested and eligible participant to their research study,” adds the Sano Genetics CEO.
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At Battery, a central part of our consumer investing practice involves tracking the evolution of where and how consumers find and purchase goods and services. From our annual Battery Marketplace Index, we’ve seen seismic shifts in how consumer purchasing behavior has changed over the years, starting with the move to the web and, more recently, to mobile and on-demand via smartphones.
The evolution looks like this in a nutshell: In the early days, listing sites like Craigslist, Angie’s List* and Yelp effectively put the Yellow Pages online — you could find a new restaurant or plumber on the web, but the process of contacting them was largely still offline. As consumers grew more comfortable with the web, marketplaces like eBay, Etsy, Expedia and Wayfair* emerged, enabling historically offline transactions to occur online.
More recently, and spurred in large part by mobile, on-demand use cases, managed marketplaces like Uber, DoorDash, Instacart and StockX* have taken online consumer purchasing a step further. They play a greater role in the operations of the marketplace, from automatically matching demand with supply, to verifying the supply side for quality, to dynamic pricing.
The key purpose of being end-to-end is to deliver an even better value proposition to consumers relative to incumbent alternatives.
Each stage of this evolution unlocked billions of dollars in value, and many of the names listed above remain the largest consumer internet companies today.
At their core, these companies are facilitators, matching consumer demand with existing supply of a product or service. While there is no doubt these companies play a hugely valuable role in our lives, we increasingly believe that simply facilitating a transaction or service isn’t enough. Particularly in industries where supply is scarce, or in old-guard industries where innovation in the underlying product or service is slow, a digitized marketplace — even when managed — can produce underwhelming experiences for consumers.
In these instances, starting from the ground up is what is really required to deliver an optimal consumer experience. Back in 2014, Chris Dixon wrote a bit about this phenomenon in his post on “Full stack startups.” Fast forward several years, and more startups than ever are “full stack” or as we call it, “end-to-end operators.”
These businesses are fundamentally reimagining their product experience by owning the entire value chain, from end to end, thereby creating a step-functionally better experience for consumers. Owning more in the stack of operations gives these companies better control over quality, customer service, delivery, pricing and more — which gives consumers a better, faster and cheaper experience.
It’s worth noting that these end-to-end models typically require more capital to reach scale, as greater upfront investment is necessary to get them off the ground than other, more narrowly focused marketplaces. But in our experience, the additional capital required is often outweighed by the value captured from owning the entire experience.
Many of these businesses have reached meaningful scale across industries:
Image Credits: Battery Ventures (opens in a new window)
All of these companies have recognized they can deliver more value to consumers by “owning” every aspect of the underlying product or service — from the bike to the workout content in Peloton’s case, or the bank account to the credit card in Chime’s case. They have reinvented and reimagined the entire consumer experience, from end to end.
As investors, we’ve had the privilege of meeting with many of these next-generation end-to-end operators over the years and found that those with the greatest success tend to exhibit the five key elements below:
The end-to-end approach makes the most sense when disrupting very large markets. In the graphic above, notice that most of these companies play in the largest, but notoriously archaic industries like banking, insurance, real estate, healthcare, etc. Incumbents in these industries are very large and entrenched, but they are legacy players, making them slow to adopt new technology. For the most part, they have failed to meet the needs of our digital-native, mobile-savvy generation and their experiences lag behind consumer expectations of today (evidenced by low, or sometimes even negative, NPS scores). Rebuilding the experience from the ground up is sometimes the only way to satisfy today’s consumers in these massive markets.
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I had my first telehealth consultation last year, and there’s a high probability that you did, too. Since the pandemic began, consumer adoption of remote healthcare has increased 300%.
Speaking as an unvaccinated urban dweller: I’d rather speak to a nurse or doctor via my laptop than try to remain physically distanced on a bus or hailed ride traveling to/from their office.
Even after things return to (rolls eyes) normal, if I thought there was a reliable way to receive high-quality healthcare in my living room, I’d choose it.
Clearly, I’m not alone: a May 2020 McKinsey study pegged yearly domestic telehealth revenue at $3 billion before the coronavirus, but estimated that “up to $250 billion of current U.S. healthcare spend could potentially be virtualized” after the pandemic abates.
That’s a staggering number, but in a category that includes startups focused on sexual health, women’s health, pediatrics, mental health, data management and testing, it’s clear to see why digital-health funding topped more than $10 billion in the first three quarters of 2020.
Drawing from The TechCrunch List, reporter Sarah Buhr interviewed eight active health tech VCs to learn more about the companies and industry verticals that have captured their interest in 2021:
Full Extra Crunch articles are only available to members
Use discount code ECFriday to save 20% off a one- or two-year subscription
Since COVID-19 has renewed Washington’s focus on healthcare, many investors said they expect a friendly regulatory environment for telehealth in 2021. Additionally, healthcare providers are looking for ways to reduce costs and lower barriers for patients seeking behavioral support.
“Remote really does work,” said Elizabeth Yin, general partner at Hustle Fund.
We’ll cover digital health in more depth this year through additional surveys, vertical reporting, founder interviews and much more.
Thanks very much for reading Extra Crunch this week; I hope you have a relaxing weekend.
Walter Thompson
Senior Editor, TechCrunch
@yourprotagonist
Image Credits: Luis Alvarez (opens in a new window) / Getty Images
Image Credits: Bryce Durbin
In the last year, edtech startup Top Hat acquired three publishing companies: Fountainhead Press, Bludoor and Nelson HigherEd.
Natasha Mascarenhas interviewed CEO and founder Mike Silagadze to learn more about his content acquisition strategy, but her story also discussed “some rumblings of consolidation and exits in edtech land.”
Image Credits: Nigel Sussman (opens in a new window)
Last year, U.S.-based VCs invested an average of $428 million each day in domestic startups, with much of the benefits flowing to fintech companies.
This morning, Alex Wilhelm examined Q4 VC totals for Europe, which had its lowest deal count since Q1 2019, despite a record $14.3 billion in investments.
Asia’s VC industry, which saw $25.2 billion invested across 1,398 deals is seeing “a muted recovery,” says Alex.
“Falling seed volume, lots of big rounds. That’s 2020 VC around the world in a nutshell.”
Image Credits: Treedeo (opens in a new window) / Getty Images
In this week’s Decrypted, security reporter Zack Whittaker covered the latest news in the unfolding SolarWinds espionage campaign, now revealed to have impacted the U.S. Bureau of Labor Statistics and Malwarebytes.
In other news, the controversy regarding WhatsApp’s privacy policy change appears to be driving users to encrypted messaging app Signal, Zack reported. Facebook has put changes at WhatsApp on hold “until it could figure out how to explain the change without losing millions of users,” apparently.
Image Credits: Nigel Sussman (opens in a new window)
A big IPO debut is a juicy topic for a few news cycles, but because there’s always another unicorn ready to break free from its corral and leap into the public markets, it doesn’t leave a lot of time to reflect.
Alex studied companies like Lemonade, Airbnb and Affirm to see how well these IPO pop stars have retained their value. Not only have most held steady, “many have actually run up the score in the ensuing weeks,” he found.
Image Credits: Bryce Durbin / TechCrunch
Dear Sophie:
I work in HR for a tech firm. I understand that Biden is rolling out a new immigration plan today.
What is your sense as to how the new administration will change business, corporate and startup founder immigration to the U.S.?
—Free in Fremont
Image Credits: atakan (opens in a new window) / Getty Images
I began my career as an avid TechCrunch reader and remained one even when I joined as a writer, when I left to work on other things and now that I’ve returned to focus on better serving our community.
I’ve been chatting with some of the folks in our community and I’d love to talk to you, too. Nothing fancy, just 5-10 minutes of your time to hear more about what you want to see from us and get some feedback on what we’ve been doing so far.
If you would be so kind as to take a minute or two to fill out this form, I’ll drop you a note and hopefully we can have a chat about the future of the Extra Crunch community before we formally roll out some of the ideas we’re cooking up.
Drew Olanoff
@yoda
Image Credits: Nigel Sussman (opens in a new window)
Last year was a disaster across the board thanks to a global pandemic, economic uncertainty and widespread social and political upheaval.
But if you were involved in the private markets, however, 2020 had some very clear upside — VCs flowed $156.2 billion into U.S.-based startups, “or around $428 million for each day,” reports Alex Wilhelm.
“The huge sum of money, however, was itself dwarfed by the amount of liquidity that American startups generated, some $290.1 billion.”
Using data sourced from the National Venture Capital Association and PitchBook, Alex used Monday’s column to recap last year’s seed, early-stage and late-stage rounds.
Image Credits: Andy Roberts (opens in a new window) / Getty Images
Building a marketing team is one of the most opaque parts of spinning up a startup, but for a deep tech company, the stakes couldn’t be higher.
How can technical founders working on bleeding-edge technology find the right people to tell their story?
If you work at a post-revenue, early-stage deep tech startup (or know someone who does), this post explains when to hire a team, whether they’ll need prior industry experience, and how to source and evaluate talent.
Bustle Digital Group CEO Bryan Goldberg. Image Credits: Bustle Digital Group
Senior Writer Anthony Ha interviewed Bustle Digital Group CEO Bryan Goldberg to get his thoughts on the state of digital media.
Their conversation covered a lot of ground, but the biggest news it contained focuses on Goldberg’s short-term plans.
“Where do I want to see the company in three years? I want to see three things: I want to be public, I want to see us driving a lot of profits and I want it to be a lot bigger, because we’ve consolidated a lot of other publications,” he said.
Image Credits: Laia Divols Escude/EyeEm (opens in a new window) / Getty Images
The U.S. Federal Trade Commission is not a huge fan of personal-care D2C brands merging with traditional consumer product companies.
This month, razor startup Billie and Proctor & Gamble announced they were calling off their planned merger after the FTC filed suit.
For similar reasons, Edgewell Personal Care dropped its plans last year to buy Harry’s for $1.37 billion.
In a harsher regulatory environment, “the path to profitability has become a more important part of the startup story versus growth at all costs,” it seems.
SAN FRANCISCO, CA – SEPTEMBER 12: Founder and CEO of Twilio Jeff Lawson speaks onstage during TechCrunch Disrupt SF 2016 at Pier 48 on September 12, 2016 in San Francisco, California. Image Credits: Steve Jennings/Getty Images for TechCrunch
Companies that build their own tools “tend to win the hearts, minds and wallets of their customers,” according to Twilio CEO Jeff Lawson.
In an interview with enterprise reporter Ron Miller for his new book, “Ask Your Developer,” Lawson says founders should use developer teams as a sounding board when making build-versus-buy decisions.
“Lawson’s basic philosophy in the book is that if you can build it, you should,” says Ron.
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Hims & Hers, a San Francisco-based telehealth startup that sells sexual wellness and other health products and services to millennials, began trading publicly today on the NYSE after completing a reverse merger with the blank-check company Oaktree Acquisition Corp.
Its shares slipped a bit, ending the day down 5% from where they started, but the company, which was founded in 2017 and now claims nearly 300,000 paying subscribers for its various offerings, has never been focused on a splashy headline about its first-day performance, co-founder and CEO Andrew Dudum told us earlier today.
On the contrary, Dudum says that while Hims might have once imagined a traditional IPO, it decided to go the special purpose acquisition company (SPAC) route because of their pricing mechanisms and because it was approached by a SPAC led by renowned money manager Howard Marks, the founder of the global alternative investment firm Oaktree Capital Management. (“We fell in love with the Oaktree team and the capital market experience and deep resources they have.”)
We talked with Dudum about that SPAC’s structure; the lockups involved now that Hims’ shares are trading; and how much of the business still centers around one of its first offerings, which was a generic version of erectile dysfunction pills. Our conversation has been edited lightly for length and clarity.
TC: You’re a Bay Area-based company selling to a mostly U.S. audience. How are you thinking about expanding that footprint geographically?
AD: We do have a small operation selling in the U.K.; we’re getting our feet wet in that market and building out a team and infrastructure and fulfillment. If you look at the regulatory landscape, there’s a huge amount of room [to grow] in Europe, Australia, Canada, the Middle East and Asia, and so in that order, we’ll start to [move into those markets].
TC: What is your average customer cost?
AD: It has come down from $200 when we first launched, to roughly $100 last year, and we make, on average, close to $300 in the first couple of years in terms of a patient’s lifetime value.
TC: How quickly do customers churn?
AD: We break down lifetime value projections by quarter cohorts, and quarter over quarter, year over year, we’re monetizing each of these cohorts better, with high-margin profiles.
As of last quarter, the business was growing 90% year-over-year, with 76% gross margins and greater cash efficiency, and that’s because as we provide more offerings, there is more cross-purchasing. Also, word of mouth is becoming more of a dynamic, with more than 50% of the traffic to the site free at this point because we have built a brand with a young demographic.
TC: When are you projecting that you’ll turn profitable?
AD: We’ve reduced our annual burn and increased our margin efficiency and organic growth, so on a quarterly basis, we think in the next couple of years is a real possibility.
Image Credits: Hims & Hers
TC: Hims’ first wellness offerings included pills for male pattern hair loss and erectile dysfunction. How much revenue does that ED business account for?
AD: What we’ve disclosed is that roughly half [of our revenue] is that sexual health category — which includes [medicines for] generic erectile dysfunction, birth control, STDs, UTIs and premature ejaculation. The other half is predominately dermatology, including hair care [to address hair loss] and acne, and we’ve more recently moved into primary care and behavioral health.
TC: For retail investors, how do you differentiate the business from that of your rival Ro, which heavily promotes its ED products?
AD: There are a number of core differences between us and public and private players. First is our real focus on diversifying our offerings. With our focus on sexual health, dermatology, primary care and behavioral health, it’s in our DNA to quickly expand into new businesses.
We also think we’re different from most [rivals] in that we really invest time in building deep relationships with [those who represent] the future of healthcare markets — people in their teens, 20s and 30s. This demographic has a different set of tech expectations and consumer expectations than people in their 40s, 50s and 60s, and if we want to build for the future, that means building for the largest body of payers in the future.
Traditional healthcare companies monetize only the sick, but optimizing around that demographic precludes you from understanding what the next generation really needs and wants. I’ve never seen such a divergence between a patient population and legacy experience, and that’s a real advantage to us as a business.
TC: Hims just went public through a SPAC in a deal that gives the company around $280 million in cash — $205 million of that from Oaktree’s blank-check company and another $75 million through a private placement deal. How much runway does that give you?
AD: The company doesn’t burn a tremendous amount — between $10 million and $20 million a year — so a relatively long runway if we keep operating the business as is. But it does allow us to expand and grow into new businesses, too, including into big categories like sleep, infertility, diabetes and other chronic conditions.
TC: What about acquisitions?
AD: We’ll keep an eye open for strategic opportunities and consolidation opportunities. More than a dozen businesses a month come to us to be consolidated into the brand, but generally speaking, we’ve had the belief that so much is in front of us that we don’t want to be distracted.
TC: Is there a lockup period for anyone?
AD: There’s a traditional lockup for executives and employees and the board.
TC: Did your SPAC sponsors get a board seat?
AD: No.
TC: How much do they now own of the company, and can they sell?
AD: Oaktree owns a couple percent and [the syndicate they brought to do the private placement] [owns] 12%. But the very reason we went with them was the quality of the team and the organization . . . and they have the added incentive for the next year or two from a compensation standpoint for the company to succeed and to prove [out their thesis that Hims is a smart investment].
TC: Do you think the traditional IPO process is broken?
AD: The traditional IPO market hasn’t changed. It takes 12 to 18 months of preparation, which is a crazy amount of time for management to be distracted, then there’s this one-day PIPE that gives institutions a tremendous amount of money instantaneously. Maybe it makes for a good CNBC headline, but at tremendous cost to the company. It’s atrocious. If you were a founder or employee and getting diluted twice as much as you have to be, you’d be really upset. It’s no surprise to me that founders like myself are looking at other modalities with better pricing and better structures.
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Last week, Procter & Gamble (P&G) announced that it was terminating plans to acquire razor startup Billie following a U.S. Federal Trade Commission lawsuit to stop the deal.
Last year, Edgewell Personal Care ditched its debt-heavy $1.37 billion deal for Harry’s, Inc, formerly valued at $1 billion after the FTC sought to block the acquisition.
In addition to these FTC challenges, it is also now becoming clear that relying on VC-subsidized products and celebrating outrageous valuations can be problematic for D2C brands. With a few wonderful and rare exceptions such as Rothy’s (which raised $42 million but was profitable from the beginning and generated $140 million in revenue within two years of launching), D2C unicorns are addicted to the cycle of venture funding to feed growth in order to maintain a high valuation multiple.
The path to profitability has become a more important part of the startup story versus growth at all costs.
This works for a while; however, when the path to profitability appears murky and exit options either don’t appear or only appear from nontech companies with very conservative multiples, the walls start crumbling.
In a WWD article, Odile Roujol, the former CEO of Lancôme who launched venture fund FAB Ventures, said, “Generally speaking, the era of $1 billion valuations for beauty companies is over. The people that struggle have been the companies that spend so much money in just a few years.” She went on to say, “The big corporations now … are not ready to spend $1.2 billion, $1.5 billion on such a brand like Glossier.”
This change in sentiment from acquirers is further fueled by recent research on the challenges of turning hypergrowth companies profitable. In his Harvard Business School case study “Direct to Consumer Brands,” Professor Sunil Gupta wrote, “Acquiring DTC brands is easy for incumbent conglomerates, but making them profitable is challenging. More than three years after Unilever acquired Dollar Shave Club, it was still unprofitable.”
Unilever executives learned that the average cost of acquiring a new customer online was about the same as in stores. David Taylor, CEO of P&G, said his company was still figuring out how to turn recently acquired direct-to-consumer brands into profitable businesses.
Taylor summarized this dilemma, saying, “There are many, many launches that grow fast … a business model that makes money is a higher challenge.” Since making these realizations, incumbent conglomerates will be more cautious when considering the acquisition of hyped D2C brands that raised lots of venture capital.
What’s cooler than beauty companies that are (or were) valued at $1 billion? Beauty tech SaaS companies that are worth $5.2 billion at IPO. We don’t hear much about the leading global beauty tech companies such as Meitu and Perfect Corp. because their founders are not celebrity influencers, they don’t have massive Instagram followings here in the U.S. and they are not celebrated in our media. Although their companies are based in Asia and they raised money mostly from Chinese investors, their companies are global successes.
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The COVID-19 pandemic shined a harsh spotlight on the challenges many elderly people face. Older adults are among the highest-risk groups for developing cases that need hospitalization and nursing homes were especially vulnerable to outbreaks. While dealing with COVID-19, the elderly have also faced many other problems, including the difficulty of accessing medical care for chronic conditions during lockdowns and isolation.
Many of these issues won’t go away after the pandemic. According to the United Nations, the global population of people 65 and over is growing faster than any other age group. At the same time, there is a critical shortage of caregivers, especially for elderly people who want to continue living at home instead of moving into nursing homes.
Tech can help in many ways: By helping caregivers (and reducing burnout), allowing seniors to perform health monitoring at home and creating tools to combat isolation. During CES, there were several “age-tech” presentations. One of the most notable was AARP Innovation Lab, the nonprofit’s startup accelerator program. It presented nine companies at the virtual show.
One common theme among AARP’s group was tech that helps elderly people “age in place,” or stay in their homes or communities instead of moving into a nursing home. For example, Wheel Pad designs accessible home and work spaces that can be installed into existing structures and sites. Mighty Health is an app that pairs users with health coaches, certified trainers and personalized nutrition plans, while Zibrio, a scale that assesses users’ balance to predict if they are at risk for a fall, can also be incorporated into at-home routines.
Other startups from AARP Innovation Lab focus on helping caregivers, too. For example, FallCall Solutions’ creates Apple Watch apps that send alerts if a fall is detected and help family members check on users. Another app, called Ianacare, helps family members coordinate caregiving tasks and ask for support. End-of-life planning is one of the most emotionally difficult processes for families, and Cake, an “end-of-life platform” helps by providing tools for estate and health care planning, as well as resources to help relatives cope with caregiving issues and grief.
Other startups center on medical care. For people with chronic conditions, Folia Health helps monitor the progress of treatments. On the clinical side, Embleema’s software allows clinical investigators to share data and design studies, making pharmaceutical research more efficient.
Other noteworthy age-tech startups at CES included Nobi, a smart lamp that automatically turns on when users stand up and sends alerts to family members if they fall. Nobi can also be used in residences and nursing homes.
Caregiver Smart Solutions is a multifaceted platform that makes it easier for seniors to stay at home with a machine-learning-based app for early detection of potential health issues, fall sensors, monitors and emergency buttons. For people with incontinence, DFree, a wearable device, can reduce stress by monitoring how full their bladder is with an ultrasound sensor and keeping track of their average time between bathroom visits. It’s available for both consumers and healthcare facilities.
For elderly people living in nursing homes, Rendever is a virtual reality platform that wants to help reduce isolation. It can be used with reminiscence therapy, which guides individuals with dementia through experiences that remind them of their pasts and to allow virtual travel to landmarks. Cutii, a companion robot, also seeks to reduce loneliness. While companion robots have been a mainstay of CES for years, Cutii sets itself apart with entertainment like music, games and live events. It also has video call and night patrol features.
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One in five people have a mental health illness. Pace, a new startup founded by Pinterest and Affirm executives, wants to pay attention to the other four in that statistic.
“Nobody is perfectly mentally healthy all the time,” said Jack Chou, Pace co-founder. “It’s a non-existent idea, everyone is sort of swimming in between being clinically mentally unhealthy and perfectly mentally happy.”
While diagnosable mental health conditions might get an individual medication or therapy, those that live in a grey space might still need resources to stay afloat. After Chou experienced the detrimental effects of burnout while working for Pinterest and Affirm, and co-founder Cat Lee, formerly of Pinterest and Maveron, experienced a personal travesty, the former colleagues realized there needed to be a way to help people who didn’t fit squarely into one bucket.
So Pace, which launched out of private beta today, wants to address this fallacy by creating small-group training classes for people interested in taking care of their emotional and mental health. It is launching with $1.9 million in seed funding. Investors include Nellie and Max Levchin, Jeff Weiner, Emilie Choi, Ben Silbermann, Box Group, and SV Angel.
The core of the product is a 90-minute live video group session once a week, delivered through Pace’s platform. The video component integrates with Twilio and Agora (and interestingly, not Zoom, because its SDK lacks personalization options). Users can attend the sessions on Web, iOS or Android.
Image Credits: Pace
Pace forms cohorts of eight to 10 people around shared interest or identities, such as a founder group or parent group. Then, Pace interviews a new user for 15 to 30 minutes to learn about what they hope to get out of the experience.
Once a group is formed, they meet weekly with a facilitator at the helm. While it’s not trying to be a therapy replacement, the startup is looking for facilitators who are licensed in mental health practice. To help them do this, Pace secured two founding members who are psychologists: Dr. Kerry Makin-Byrd and Dr. Vivian Oberling.
When users sign on, they are prompted to pick three words that describe themselves from dozens of options. Those words show up under their video as they talk, and help skip some small talk in the beginning of the sessions.

The group talks about a variety of topics, from how to manage stress to how to adapt to a remote world. There is no formal curriculum, but each class has a takeaway for participants to leave with.
Pace doesn’t follow any specific curriculum during the meetings, but instead uses the time for people to talk through their feelings. Facilitators are licensed mental health clinicians, with the majority of the leaders being part-time or freelancers. It plans to introduce asynchronous ways for group members to chat and stay in touch beyond the weekly class, as well as spend time building out a product that feels beyond a Zoom call.
Mental health software startups are on a tear right now. Last month, Lyra Health raised $175 million at a $2.25 billion valuation to connect employees to therapists and mental health services. Another telehealth provider, Talkspace, announced today that it was going public through a SPAC. There’s also Calm, last valued at $2 billion, and Headspace, its biggest competitor in the mindfulness app space.
Pace’s focus is more similar to the latter than the former: It’s avoiding the telehealth label and positioning itself more as supplementary to formal health services.
“Our hope is that as [therapists] have individual patients who they’d like to incorporate some group work, or need a next thing, that we’re here for that too,” says Chou.
One of Pace’s closest competitors is Coa, which launched with $3 million in seed funding in October 2020. The startup is similarly using small-group fitness culture and applying it to mental health. It mixes lecture-style teaching with breakout sessions to breed conversation.
Pace wouldn’t expand on how it differentiates from Coa beyond alluding to upcoming product features and community investments. Coa charges $25 for drop-in classes (sticking to that fitness class theme) while Pace charges $45 per week for the same group to meet for months at a time. While Coa has licensed therapists, Pace has licensed mental health clinicians.
Coa co-founders Alexa Meyer and Dr. Emily Anhalt say their service is unique from Pace in a curriculum perspective.
“Although all of Coa’s classes are facilitated by licensed therapists, Coa’s classes are different from group therapy,” Meyer said. Coa uses Anhalt’s research around mental happiness to create programming. Both companies are still pre-launch, but Coa says it has 6,000 people on its waitlist.
For both startups, the hurdles ahead are common for any startup: customer acquisition, effectiveness in tracking outcomes and scaling an innately emotional and personalized experience. As Homebrew’s Hunter Walk pointed out in a recent blog post, vulnerable populations being exposed to venture-level risk is a difficult phenomenon. Startups fail often, and in this case, that could mean leaving without once-critical support people who are depending on group therapy.
Going forward, the real winner in the mental health fitness space will come down to a thoughtful curriculum and a user experience that brings out vulnerability in people even over a virtual setting. Regardless, innovation pouring into the sector couldn’t come at a better time.
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Eating less meat is the easiest way for anyone to lower their carbon footprint, and the prepared food delivery startup Thistle has just raised $10.3 million to make that choice even easier for consumers.
The company delivers plant-based full menus (with meat options available for customers that want them) for its customers, along with a range of juices and sides.
That pitch of making tweaks to customer behavior for more conscious consumerism and healthy eating was enough to attract Series B funding from PowerPlant Ventures, with participation from Siddhi Capital, Alumni Ventures Group and the venture arm of Rich Products Corp.
The company said it would use the financing to expand geographically — setting up a production facility on the East Coast to bring its healthy prepared meals to potential customers along the Eastern seaboard.
“With this funding, we’ll be able to support even more people through scientific, evidence-based principles of nutrition that lead to optimal wellness, enjoyable eating, and a healthier planet,” said Ashwin Cheriyan, co-founder and CEO of Thistle in a statement.
Since its launch seven years ago, Thistle has served more than 5 million meals, and is intent to not just launch in new geographies, but provide more robust services for its customers. Those services will include virtual consultations with an in-house registered Thistle dietitian who can give customers guidance on the best diet for their needs, the company said.
The new offering was born from customer feedback, according to chief operating officer and Thistle co-founder Shiri Avnery.
“We tested the program last fall, and the responses were overwhelmingly positive. We’re excited to be able to officially roll out the program to our customers this month, with the primary goal to further support our customers along each stage of their wellness journey,” Avnery said.
The husband and wife duo offer menu plans starting at $42 a week or $11.50 per meal, according to the company’s website, and all meals are gluten and dairy-free (with vegan options available).
The financing for Thistle comes during a plant-based food boom that’s been sweeping the nation — and the nation’s investors.
“Eating a plant-forward diet is the single most impactful way to reduce your overall environmental footprint, reducing climate change, pollution, resource consumption, and species extinction,” said Dan Gluck, managing partner of PowerPlant Ventures, in a statement. “Consumer demand for plant-based foods is outperforming total food growth today, and this trend is expected to increase over the next decade as more people realize that eating more plants is a critical component to the long-term health of both the planet and our population.”
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