Francis deSouza

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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Next one up, Flagler Health! In an attempt to demystify some of the non-obvious elements we found when we first met the founders of our fastest growing portfolio companies at 186 Ventures, here is the third edition of the "idiosyncratic phenomenon". This highlight will be on Albert Katz, Leon Anijar, and Will Hu and their journey building Flagler Health to bring unprecedented AI enabled patient care to the world of musculoskeletal (MsK) providers. As the healthcare industry shifts to a value based care paradigm, there will be increased pressure on the entire industry to ensure patient outcomes improve, all the while helping providers generate more revenue / become more cost efficient. Since we co-led their March, 2024 seed round with Streamlined, the company has rolled out some of their newest remote therapeutic and chronic condition management features to many patients and providers alike, experiencing high revenue growth in such a short period of time. The company continues to face unmet customer demand as it continues to scale its expansion into 2025. https://lnkd.in/exesTcmC

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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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Anne Wojcicki, CEO of 23andMe, has announced plans to take the genetic testing company private. This strategic move aims to provide more flexibility in navigating regulatory challenges and to accelerate growth opportunities. The decision follows a trend of health tech companies seeking private ownership to focus on long-term objectives. Wojcicki highlighted the importance of this shift to maintain the company's commitment to innovation and customer-centric services. Taking 23andMe private reflects a bold step towards enhancing its position in the rapidly evolving genomics industry. Read more about this exciting development here: https://lnkd.in/gdrC3a64 #genomics #IPO #privatisation #23andMe

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👀 HOW DO WE GET DIGITAL HEALTH TO REFOCUS ON PREVENTATIVE CARE?👀 Enter Inbal Tirosh co-founder and CEO of the incredible Livez on this week's episode!! My favorite question to ask founders is what is your founding story? Tune in to hear Inbal explain her founding story, and how they are impacting patients lives and futures! Livez is built to make preventative care easy, convenient, and reduce claims. The Livez screening solution detect 85% of preventable diseases!! Reduces a whopping 75% of healthcare claims. How do they do this? Inbal jumps into it all with me, explaining, "All together if you take every person and they get a plan of what they need to get screened for, based on their individual profile, and their specific data, you can do that with fusion of big data, and you take them on a journey to prevent their predicted risks, based on family history and their own history and so on..." Then you automatically book them with follow up appointments. This is backed by health authorities, and by large insurers! Key Points 🗝 🌐 Livez screening solution covers more than 50 clinical domains and 120 screenings and vaccines, impacting 75% of healthcare claims. Livez is a preventive health platform that focuses on holistic screening and interventions to prevent chronic diseases. 🏥 The platform helps employers and health plans prioritize the health of their population by identifying health risks and guiding individuals towards appropriate interventions. This is an absolutely fascinating conversation about the new frontier of preventative care. Get on board, and tune in to this week's episode of the Digital Health Heavyweights Podcast Also- major teaser that their pricing is FULLY at risk. Why NOT? Learn more about preventative care, and how Digital Health is continuing to evolve!

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

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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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💡Benchmarks in the investment industry serve as a standard for measuring the performance of securities, mutual funds, or investment managers. They provide a reference point for analyzing allocation, risk, and return of a portfolio, enabling investors to make informed decisions. Thanks Peter Walker for keeping us all informed!! Can’t wait for this!! Follow and get on the waitlist for this one! #benchmarks #fundraising #Capitalraise #founders #womenshealth #femhealth #medtech #wellness

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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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We are thrilled to announce that TurboDocx has successfully closed its Angel funding round, raising $75,000. This significant milestone marks a leap forward in our journey to revolutionize smart and modular document and slide deck creation, accelerated by AI. A heartfelt thank you goes out to our friends, family, early supporters and everyone that believes in our vision. Your support is not just appreciated-- but a strong vote of confidence in our mission to innovate and transform how business document creation is created. What does this mean for TurboDocx? We're reinvesting it into the business: - Focusing on Partner/Client Needs - Understanding and addressing the evolving needs of our users remains our top priority. We're here to build not just a product but a solution that truly makes a difference. - Enhanced Solutioning - We're more committed than ever to developing solutions that set new benchmarks for efficiency, re-usability, and innovation has never been stronger. - Innovation, Partner, and Channel Growth - Our investment team and advisors primarily consists of go-to-market (GTM) and implementation professionals that have already provided invaluable guidance on scaling our overall growth. Looking ahead: As we celebrate this achievement, we're mindful that fundraising is not the end goal but a milestone --a means to an end-- to build out a well oiled machine. We're excited to leverage this opportunity to further our mission, drive innovation, and exceed the expectations of our users and partners. With this said - If you'd like to be part of this exciting journey, please reach out! Stay tuned for updates, join our growing community, and let's reshape the future of document and slide deck creation together. -Nicolas https://lnkd.in/e4CGrUVB

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In vertical SaaS, the very best companies landed with a product solving a specific, burning pain point that horizontal solutions solved badly and then became broad product suites over time (ServiceTitan, Veeva Systems, Doximity, etc). My partner Gordon Ritter calls this “layering the cake”. In vertical AI, the landing wedges are much more brittle. While the painpoints they solve are very real (and often unaddressable by SaaS alone), they’re also much more likely to commodotize in the near term as the tech advances. 👀 Therefore, the need to layer the cake in vertical AI is much more urgent than in vertical SaaS. 👀 The best vertical AI CEOs not only recognize the dynamic, but talk about it openly. Helps those around them keep up the speed of innovation and their eyes on the bigger prize.

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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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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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Incredibly excited to share our updated Healthcare AI thesis. This is not a market map – in 4,000 words, we dive deeply into the research, products, business models, and market entry points that are reimagining healthcare with AI. More specifically, we cover: • Translating AI research into real-world products • Mapping modalities (software, copilots, agents, services, diagnostics, therapeutics) to problems in healthcare • Designing AI business models that unlock billion-dollar markets • Closing current gaps in healthcare AI infrastructure • Distinguishing AI platforms from point solutions Let us know what you think ⤵️

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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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In our latest publication in Health, Management, Policy, and Innovation – "Why AI Is Good for Our Health but May Hurt Our Wallets," we examine how current regulatory frameworks, reimbursement structures, and business models for AI in healthcare are decoupled, creating an environment in which AI may significantly increase costs without necessarily improving outcomes. We recommend three interconnected reforms to unlock the full potential of healthcare AI: (1) Rigorous pre- and post-deployment evaluation to verify proposed clinical value, (2) Development of assessment standards through shared guidelines, and (3) Strategic alignment of AI deployment modalities with sustainable business models – "modality-business model-market" fit 👉 https://lnkd.in/d8NiczyM Sneha Shah Jain, MD, MBA, Clinical Professor and Kevin Schulman Professor of Medicine at Stanford University, Nigam Shah, Chief Data Scientist, Michael Pfeffer, Chief Information and Digital Officer, and Linda Hoff Chief Financial Officer at Stanford Health Care

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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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A SAFE and convertible note had a baby and Wilson Sonsini Goodrich & Rosati was the midwife- out popped the D-SAFE! 👶🏽🎉 A new #climatetech funding instrument was announced by Elemental Excelerator last week. One of the company’s main goals is to support smaller, up and coming companies during the awkward “Scale Gap” phase between #VC funding and natural growth. It’s called the #DSAFE (Development Simple Agreement for Future Equity) and it aims to aid the process by giving companies a small amount of cash to overcome initial risks and expenses during the developmental stages of a product launch or company. How does it work? D-SAFE has a redemption clause meaning companies can choose to have their payments offered as a loan or convert to equity at the investor’s discretion. Funders and companies will have clear communication and expectations about where the money is going and how it will be applied to either the company or the projects at hand. Financiers and companies will work together with more #transparency, and that’s a great boon for #startups and VC alike. As of this month, Elemental has already invested using D-SAFE in eight different companies, including Dimensional Energy and Origen — both companies investing in innovative and out-of-the-box solutions to environmental issues! Seems like a win-win on the surface. What do you all think about the D-SAFE? Alfredo Coppola Momoka Ueda Tim Wagner Stephen D. Torres Olya Irzak Natsuho Toyama Noriya Tarutani Shin Ogawa

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