Other11/10/14

Ideas we’d like to fund

Malay Gandhi

Our experience funding companies at the intersection of healthcare and technology for over three years has been humbling—we are continuously surprised (both pleasantly and unpleasantly) by the problems that plague our healthcare system and the ingenuity of the solutions we see.

Entrepreneurs in our portfolio spotted—and are now tackling—problems in emergency kit processing, continuous monitoring, and diabetes prevention, in addition to many, many others. As early stage investors, we seek to invest in these types of relentless problem solvers, not underlying technologies.

While entrepreneurs enlighten us to most of the problems, a few are top of mind for us as well. The below list is clearly not comprehensive (in fact, you should read our last post on this topic for even more—all of which remain of high interest), but hopefully this helps jog some ideas.

Healthcare’s impossible CRM
There has been a clear failure of care coordination in healthcare, perhaps costing the system as much as $45B.  Physicians already attempt to coordinate care for the chronically ill, and Medicare is just now getting around to paying them for their efforts. This creates a unique opportunity for investment in the technologies that can support a 24/7 service that will only pay physicians $40.39 PMPM. Since patients will be a customer as well (they will likely pay ~20%), this product needs to make the lives of both sides significantly better.

New health insurance products
Access to hospitals and physicians (the “network”) and cost sharing between the insurer and the member (“benefit design”) are core components of a health insurance product—modulating supply and demand. Experimentation with both is rampant, but we’re not sure it has been well-guided or that failures have been unpredictable. We want to find a company that can design the insurance products of the future by successfully predicting the correct contracting mechanisms (e.g., pay for performance, bundled payments, shared savings, full capitation, etc.) for a given provider, building marketable narrow/tiered networks, and combining those with personalized benefit designs.

The Apple Watch
We want to fund the first iconic company that takes advantage of the wrist-worn screen/interface and/or its health monitoring technologies. We realize the Watch SDK is not yet available, however, WatchKit is available now and we are excited to hear your ideas (and see mockups/screen flows) around how this new device and interface can make a difference in healthcare. Many of the largest mobile digital health companies were on iPhone from day one (of third-party apps being made available) and we expect the same for the Apple Watch.

Clinical workflow
We are looking for “physician-first” companies that build tools beloved by doctors. The sad fact is, doctors enjoy medicine less and less each day and dissatisfaction has never been higher. We believe EHRs are satisfaction killers that cannot remain the center of clinical workflow and will eventually be reduced to a thin documentation layer to support billing. Enabling the provision of higher quality care is the number one driver of job satisfaction and your product must start there. Obvious bonus points here for enabling personalized health care at the point of care.

Digital therapies
We are committed to finding companies that can build software which delivers a clinical outcome (we’re fine with combination software/pill and software/hardware as long as the hardware is commodity). Our portfolio includes companies pursuing pre-diabetes, Type II diabetes, cardiovascular disease, mental health and high risk pregnancy, to name a few. We are looking for additional companies that exploit open source, validated clinical protocols and attack disease/condition areas that represent significant areas of spend. Some categories of high interest include neurodegenerative disorders, mental health, hypertension, and respiratory disease.

Genomics workflow
Genomics data is clearly moving to the cloud, despite the challenges of data I/O. We remain interested in companies that will leverage this shift to develop improved workflow tools for researchers, clinicians, and potentially even patients. We believe there is an unwieldy set of open source tools (and associated protocols) that should be packaged together with proprietary software and services for commercial exploitation, particularly in the areas of whole genome analytics, full-read visualization and multi-site collaboration.

Science fiction
We are interested in realized breakthroughs in materials, microfluidics, biochemistry, and other core sciences that unlock clinically useful (and accurate) physiological data that can be measured non- or minimally-invasively, enabling remote, continuous patient monitoring services. This is the future of biosensing wearables, and we want to fund the next generation of companies that leverage a unique physiological data set for a clinical service.

Ambition
We fund entrepreneurs with the will to go after extraordinarily large markets, including those currently dominated by middlemen that haven’t reinvented their companies for a technology-driven era. Send us your details by November 20th and we’ll support and fund your company in January.

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