Arun Penmetsa

The (Healthcare) Ground Beneath Our Feet… This year it is likely that over $10 billion will be invested in the digital health sector – a robust amount, no doubt, but inconsequential when compared to the amount of capital tied up in healthcare real estate assets, which is estimated to be $1.2 trillion by Jones Lang Lasalle. Of that amount, approximately $790 billion is in the hospital sector while the remaining $490 billion is in medical office assets. It is estimated that there are 48.6k facilities with 3.4 billion square feet of healthcare real estate, 42% of which are owned by REITs and another 33% held by other private investment vehicles. Much of the digital health investment is meant to make the physical healthcare infrastructure more productive: greater operating efficiencies, greater patient throughput, more relevant personalized care models with better outcomes. As the healthcare system is being pushed to be more distributed to lower cost sites of care, accelerated now by the rapid proliferation of automation and AI capabilities, the potential impact on healthcare infrastructure assets will be profound. Thoughts on what that might look like... https://lnkd.in/eTfAdUbS #digitalhealth Flare Capital Partners

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Hot take on a lot of early-stage digital health companies out there: You're not a tech company. Most tech-enabled care companies I've seen over the past two years are only tech-enabled in the sense that they use telehealth as their delivery mechanism for care. There are exceptions to this, of course - companies who build computer vision and applied AI tools to better the doctor-patient experience, companies who build tooling around risk scoring and stratification to enable more personalized medicine, companies who build truly novel intakes to better route patients to the appropriate care, etc. These companies have real technology chops and, if they sell it right to the market, can get credit for this from investors. But if you're truly a telehealth provider, you need to realize now that the goal post has shifted dramatically from 2021 and you're going to be valued at maturity at something like 3x EBITDA. That's profit. Not revenue. Throw a revenue multiple out the window. That's not the world we live in if you're a virtual doctor's office. Think of how that impacts venture math. If you're raising a seed round at $15M post-money (or $12M pre-money), it means you'll have to generate something like $150-200M in annual EBITDA to be a fund returner for your seed investors. Maybe even more with dilution, since telehealth businesses are not traditionally capital efficient and will likely need to raise material additional capital to reach that scale. You need to be ridiculously profitable (probably on $800M-$1B in annual revenue since you're likely going to be a 40% gross margin business). Here's the good news: you can set yourself up well (and probably be a contrarian founder relative to your peers), by talking about EBITDA growth and how you can grow into a fund-returning outcome based on realistic mature market comps. This will stand out for the investors you're pitching, even at the early stage. This is how you can beat the malaise of the tech-enabled care market. Focus on the right metrics and the right type of growth. You don't have to have all the answers (no founder does), but you need to make sure the ship is headed in the right direction. A focus on profitability for "tech-enabled care" (*ahem* telehealth) businesses is a good first step.

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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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📈 Demand for fertility services is rising -> 💼 PE recognizes this and wants in -> 🏜 but opportunities are scarce (https://lnkd.in/g6zXEVZh). Highly recommend anyone who wants a deeper understanding of what's going with fertility and fertility tech read Aya Spencer's *2024 State of fertility tech report* (https://lnkd.in/gVjK_UpX) - it's a great summary

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AI and Med Tech in Focus   AI System Developed to Identify Pathology in Tissues Engineers at Washington State University have developed an AI tool that uses images of human and animal tissue to detect abnormalities faster and more accurately than people. The AI algorithm was trained using images from past studies that involved kidney, testes, ovarian, prostate, breast and lymph node abnormalities. The new model detected disease in minutes—current processes take humans several hours and require specialized teams to check each other’s work. It was also found to be more accurate, sometimes detecting instances that humans had missed. The engineers designed the system to handle the processing load of the high-resolution gigapixel images by breaking them down into smaller tiles but still retaining the overall context of the tissue sample—akin to the zoom feature on a microscope or phone camera. Aside from getting diagnostic results more accurately and quickly, the new system also shows promise in epigenetics (the study of molecular processes that change gene behavior without changing underlying DNA). Epigenetic researchers can perform analyses and get results that used to take a year or more in just a couple of weeks. VC Investors are always adjusting their "Play Book" with a variety of options for investing. Mikal Ventures is one of those alternatives, offering curated solutions to real world problems. Reach out if you have questions on how we can be of assistance and bookmark https://mikalventures.com/ for additional insights and information.

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Excited to announce Frist Cressey Ventures' investment in Qualified Health and privileged to partner w/ SignalFire, Healthier Capital, Town Hall Ventures and others!   Healthcare costs are increasing at a faster rate than ever before, with the US spending nearly twice as other wealthy countries and still ranking bottom in outcomes. It's a story you've all heard - - US healthcare is known for astronomical inefficiencies, waste, workforce supply constraints, fragmented access, appalling patient experiences, and driving patients and businesses into debt.   Yes these problems present opportunities. But opportunities are limited to the system's appetite for change, desire and incentive to try something new and the innovation available. At FCV we believe we've hit the trifecta with Generative AI. Generative AI has given us truly transformational tools in the toolkit and the healthcare ecosystem is demanding to absorb its benefits. This perfect collision of supply and demand means healthcare is poised for big change.   Generative AI is everywhere, it's buzzy, it dangles hope and opportunity. But many things need to be true for the Gen AI transformation in healthcare to take hold, such as but not limited to:   💡 Patient lives and data need to remain safe: We believe in a highly regulated and human life-touching sector such as healthcare we must ensure Gen AI can drive to unrivalled savings and improvements in the quality of care WHILE not putting patient lives or data at risk.   💡 Systems need to own their utilization of Gen AI: We believe systems will use some hybrid of external partners and homegrown solutions but importantly will want full control of data provisioning and utilization as well as the ability to solve an unlimited number of nuanced issues and not cookie cutter algorithms.   💡 Costs need to be looked at on an enterprise level: We believe the speed of innovation in Gen AI means costs will continue decreasing dramatically but at an enterprise level this will still not be a small detail. Systems will want the ability to understand costs and delegate as needed for the outcomes desired at the organizational level.   Enter Qualified.   We knew when we met Justin Norden, MD, MBA, MPhil and team we were standing in front of changemakers. These individuals have lived and breathed the true application and implementation of Generative AI far before we were asking ChatGPT to write our emails. In fact, if you’ve ever driven in a Waymo you’ve benefited from past products this team has built.   Qualified Health is on a mission to enforce governance in Gen AI, allow systems to rapidly build for their needs, monitor and make decisions for all GenAI (homegrown and external) and accelerate the value the sector can glean from these new technologies.   Huge shout out to William T., Tommaso Auerbach and Jamie Kuntz for their hard work!

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To my amazing network - I am thrilled to announce the launch of Pave Health Ventures, an early-stage venture fund dedicated to broadening access to healthcare and improving the overall well-being of our communities. I’ve been very fortunate in my healthcare career. As the Founder & CEO of MedPilot, we capped off a seven-year journey with a successful exit when we were acquired by Vytalize Health. For the last three years, serving as Chief Innovation Officer, I’ve had the honor to contribute to the remarkable growth at Vytalize, impacting the lives of hundreds of thousands of patients by enhancing the quality of care they receive. I am immensely grateful to Matt Buder Shapiro, not only for being the perfect partner and co-founder but also for being an incredible friend. Additionally, I extend my heartfelt appreciation to Faris Ghawi, Amer Alnajar, and Jordan Brown for their outstanding leadership and for broadening my perspective on the significance of value-based care. This journey has not only provided me with industry expertise but has allowed me to cultivate invaluable relationships and an incredible network. As I embark on this new chapter, I am profoundly grateful to be supported by top executives and thought leaders in the investment, wellness, and healthcare industries. Within the healthcare ecosystem, we are represented by key stakeholders from health systems, insurers, governmental organizations, retail health businesses, provider groups, and value-based care organizations. At Pave Health Ventures, we believe the timing couldn't be more opportune to help support health-focused startups. With the growing prevalence of illness and chronic health conditions impacting our communities, consumers and key Healthcare Stakeholders are increasingly prioritizing proactive and preventative care. This shift in focus is fueling demand for technology, products, and services aimed at improving health outcomes, unlocking trillions of dollars in growth potential within the healthcare landscape. Pave Health Ventures is all-in. We are actively seeking solutions that tackle the root causes of illness, manage chronic conditions, and optimize care and care teams. Please support us in our mission by opening your networks and introducing us to amazing founders and entrepreneurs. Together, let's help pave the way to a healthier tomorrow. Jacob Myers

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Frist Cressey Ventures is absolutely thrilled to share that we've teamed up with SignalFire, Healthier Capital, Town Hall Ventures, Intermountain Ventures, and Flare Capital Partners to participate in Qualified Health's seed funding round, securing $30 million to develop the infrastructure for generative AI in healthcare. "What sets Qualified Health apart is their unique approach to healthcare AI governance," said Navid Farzad, managing partner at Frist Cressey Ventures. "Their platform enables health systems to maintain control while accelerating innovation – a crucial balance that the industry has been seeking." We're proud to support Qualified Health as they bridge the gap between AI's potential and healthcare reliability, transparency, and safety. Learn more about our new partnership at the link below: https://lnkd.in/ehVuFyJi

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#Longevity Tech is on the rise ✌️ -Endeavor BioMedicines raised $135M at a $795M valuation in April 2024. -Humanaut Health secured an $8.7M Seed round, valued at $52M in May. -Superpower raised $4M, reaching a $24M valuation in May as well. These are just 3 of the 90+ #longevity startups highlighted in Dealroom.co's latest report (Link in the comments). In this newsletter, I dive into the Longevity Technology Market and the emerging trends shaping the future of health! 👉 https://lnkd.in/e3EZrAPH #Longevity #HealthTech #StartupFunding #Innovation

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Open-source models can be a strong lever for increasing gross margins at AI companies, especially those that have hefty cost structures (e.g., enterprise sales orgs that require significant customer success or implementation resources, as well forward-deployed AI services models common in healthcare and life sciences). One of many reasons to maintain a modular and flexible stack with minimal dependencies when building an AI company. More on the importance of flexibility in the AI stack: https://lnkd.in/eA2XATRk h/t Delip Rao #ai #artificialintelligence #generativeai #healthcare

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🚨 𝗘𝘅𝗰𝗶𝘁𝗶𝗻𝗴 𝗧𝗿𝗲𝗻𝗱𝘀 𝘁𝗼 𝗪𝗮𝘁𝗰𝗵 𝗮𝘁 𝗛𝗟𝗧𝗛 𝟮𝟬𝟮𝟰 🚨 As HLTH 2024 unfolds this week, industry leaders are excited to discuss key trends and innovations reshaping healthcare.  🔹 𝗔𝘃𝗶 𝗠𝘂𝗸𝗵𝗲𝗿𝗷𝗲𝗲 (𝗩𝗲𝗿𝗮𝘁𝗼) emphasizes the critical role of trusted data when it comes to AI. With AI-powered tools like NLP, ML, and Gen AI, Avi predicts transformative improvements in ROI and care delivery. 🔹 𝗥𝗮𝗷𝗲𝗲𝘃 𝗥𝗼𝗻𝗮𝗻𝗸𝗶 (𝗟𝘆𝗿𝗶𝗰) talks about focusing on creating ethical, cross-disciplinary ecosystems where responsible AI becomes a core part of operations. 🔹 𝗖𝗼𝗹𝗶𝗻 𝗕𝗮𝗻𝗮𝘀, 𝗠𝗗 (𝗗𝗿𝗙𝗶𝗿𝘀𝘁) sees a shift towards hybrid EHR solutions, emphasizing agility and specialized partnerships over traditional monolithic systems. Check out these predictions and more. https://lnkd.in/e2vkB3sY What trends are you most excited to see at HLTH? Verato team members David Beck and Joshua Firstenberg will be onsite to discuss. #HLTH2024 #HealthcareIT #AI #EHR #PatientCare

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Generally surprised to not see more hardware vendors in healthcare and life sciences partnering with AI-first companies. When the zone of genius of a company is hardware, it's difficult to imagine that same team achieving parity on an AI product – Apple may be the greatest example of success in this realm, and still has secured many AI capabilities via targeted M&A (Siri, Turi, Xnor.ai, Voysis, Inductiv). Given the importance of leveraged distribution models in the ossified industries of healthcare and life sciences, it seems there is untapped opportunity for more hardware manufacturers to partner and co-develop AI products with startups. Control over the way data is captured and processed is critical for building high quality training data sets, which creates an interesting feedback loop between hardware companies and potential AI-first startup partners. Interested to explore this further with folks in healthcare and life sciences hardware!

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#hiring If anyone knows an awesome engineer that would be interested in joining an emerging #AI company doing important work in #healthcare, please drop me a line! Andy AI is backed by General Catalyst, YCombinator, Greater Ventures, and others, and they’re looking to hire a full stack engineer (US based) who's excited about using AI to improve healthcare and reduce nurse burnout. Andy is AI software that automates clinical documentation for nurses who do home visits. A nurse makes an audio recording of the visit and Andy automatically generates a form that usually takes nurses 90 minutes to complete. Nurses love the product because it potentially saves them 15 hours of charting a week! The founders previously built healthcare AI at Google Health and Apple, and are now building their vision to transform home health. More about Andy AI: https://with-andy.com/ Nurses love it: https://lnkd.in/g9XqZrUq #GenAI #digitalhealth #hiring #engineers #healthtech

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Some VC investors believe that brick and mortar - referring to a physical presence of some kind - should be avoided at all costs. Yet, the track record of clinic and hybrid care businesses in health care indicates otherwise. ==> One Medical (sold for $3.9 billion to Amazon), Oak Street (bought by CVS for $10.6 billion), Lifestance (IPO at $7.5 billion market cap), and PE-backed Premise Health (acquired by OMERS Private Equity for $1.1 billion) If a clinic is indicated as the optimal way to deliver care for that patient population, there are creative ways to build and operate them. Full article below with advice and strategies on how to build and operate hybrid clinics from my teammate Anarghya Vardhana from Maveron, Amir Dan Rubin from OneMedical Group, Steven Eidelman from Modern Animal and more!

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Of note: Your health records are coming to new apps This in an interesting change, and a somewhat Epic change. All puns intended. If you don’t know, the leading medical record storage solution in the US is operated by Epic. A rather critical problem is that if you walk (well drive) between two hospital in the US, the medical records tend not to follow you, unless you carry a large Manila envelope. Having Epic (and others) via TEFCA allow export of records arguably allows you to only carry your phone, which is a very siginificant change. This also (arguably) opens up a huge new innovation sector. Epic is one of the organizations that has been helping the US federal government establish the Trusted Exchange Framework and Common Agreement, or TEFCA. The goal being to iron out both the legal and technical requirements for sharing patients' data at scale. Health-care data in the U.S. has historically been siloed and difficult to move around. Clinics, hospitals and health systems can store their information in a variety of formats across dozens of different vendors, and there hasn't been a trusted nationwide mechanism in place for transporting it securely. This means if a patient moves to a different state or visits a new hospital, their medical records tend not follow. PS. If you want appreciate how profitable the US medical sector is, Epic HQ has a restantant designed to look like Kings Cross from the Harry Potter movies. https://lnkd.in/g8NaWza8

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I’m optimistic about the potential of generative AI to reduce provider burnout and improve provider-patient interactions. However, that optimism is tempered by the data that indicates the technology is not quite ready yet. Bright Ventures is interested in digital health founders who understand the realities of provider-patient interactions, and the role technology can play in strengthening clinical outcomes. Which founders and teams are getting this right? Tag them in the comments below.

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With Americans over 65 projected to grow from 58 million to 82 million by 2050, AI solutions like Foundation Capital portco SafelyYou are becoming increasingly crucial. They’re also a powerful answer to the industry’s persistent staffing shortages, acting as a force multiplier for caregivers. The benefits extend beyond individual residents and their families. For senior living homes, SafelyYou’s AI-powered fall prevention and response system translates to longer lengths of stay and higher net operating income (NOI). With AI, we are working towards a future where every individual—regardless of age or health status—receives the highest quality care, tailored to their unique needs and circumstances. Companies like SafelyYou are leading the charge in making this future a reality, and I’m immensely proud to work alongside them as they use AI to build a better world.

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This week's launch of Ask Avo (see announcement below) has truly excited healthcare leaders across the market! Here's 3 reasons why: 🩺 Ask Avo simplifies the way clinicians treat patients to help them tackle the growing complexities of patient care. With a constant streams of new evidence, growing prevalence of chronic diseases, rapid growth of available treatments, ongoing reimbursement changes, and resource constraints, clinicians need a simpler way of accessing information. 💻 Ask Avo is seamlessly integrated in the EHR (or available for use outside of it) enabling AI adoption to move swiftly without IT hassle or clinician disruption. AI has massive potential to improve patient outcomes and reduce physician burnout, but without seamless integration and an easy user experience, health systems won't adopt it and clinicians won't use it. Ask Avo gives clinicians what they need by asking it a single question. 🏥 Ask Avo helps health systems meet the increasing challenge of dealing with physician shortages. With physician shortages at an all time high, healthcare leaders are looking for ways to empowering APPs and other clinical support staff with the evidence and tools they need to take on more patient facing roles. See the announcement here: https://lnkd.in/eCWExGKB Thanks to HIT Consultant Media, HLTH Inc., Hospital Management, and Elion for helping us share the news! #HealthcareAI #AIchatbot #medicalchatbot #EHRs #healthtech

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