Pandemic’s shift to remote wellness helps Numan raise $40M Series B led by White Star

Numan, the European subscription service covering erectile dysfunction (ED) and men’s wellness/health needs more generally, has raised $40 million in a Series B funding round led by White Star Capital, with participation from existing investors Novator, Vostok New Global, Anthemis Exponential, Colle Capital, and new investor Hanwha Group. The new round will be used to fuel expansion.

Numan’s current roster of services cover ED, premature ejaculation, hair loss, gut and lung health, and nutritional deficiencies. But they can also do blood tests for general health needs which don’t require in-person appointments.

Post-pandemic, the digitization of health and wellness continues apace. Had we not had a pandemic, vitamins, and the like, delivered through the letterbox, would almost certainly have continued to grow steadily as a business. But with the pandemic, businesses that can speak to our health needs remotely have exploded.

Who would have considered taking a blood test remotely a ‘normal thing’ two years ago? Now it’s practically required. Into this space, wellness companies have uncovered an extremely lucrative nexus of trends: an aging male population with a desire to remain sexually active, increasing awareness of their own health, the convenience of subscription, and the imperative of the pandemic to keep things remote has proven to be a powerful combination of forces.

Numan is not alone in this space. Roman and Hims, for example, are two big players in the US. The open door Numan is pushing against is more this wider movement around male health, which men themselves are becoming more open to. As well as growing organically, Numan has also made two strategic acquisitions of companies in the UK and Sweden to expand its footprint. It’s likely this new round will lead to similar strategic plays.

With sexual health a tricky subject for men, digital services are stepping in to mitigate any embarrassment around having to sit in front of the family GP. Numan is also regulated by the Care Quality Commission as a registered healthcare provider, giving it a further stamp of approval.

Numan claims men now prefer its model to in-person healthcare meetings. In its own survey of 800 subscribers, 88% said that using the service has improved their confidence, while 68% say that using Numan has also improved their relationships, and over half said the effects of the pandemic had given them a more positive impression of using digital healthcare.

In a statement Sokratis Papafloratos, CEO & founder, Numan said: “This funding is a significant milestone on our journey to help millions of men be healthier. White Star Capital is one of the best investors in our space, and I’m delighted to be working together along with a wider team of brilliant investors.”

Speaking to me over a call, Papafloratos added that despite there being a lot of competition in the space “this is not a winner-takes-all-market. We have 25 languages on the team so we understand the market, patients, regulation, we understand it more in-depth than many competitors.”

Eric Martineau-Fortin, Founder and Managing Partner, White Star Capital: “Men’s health has been under-served by traditional services and needs innovative businesses to break down barriers and ensure taboos don’t prevent men from being happy and healthy. Numan’s digital offering helps men take charge of their health discreetly and decisively. We’re incredibly excited by Sokratis and his team, and look forward to working with them as they grow.”

#ceo, #digital-health, #digital-healthcare, #erectile-dysfunction, #europe, #healthcare, #managing-partner, #musicians, #numan, #sokratis-papafloratos, #sweden, #tc, #united-kingdom, #united-states, #white-star-capital

Joshua Kushner’s Thrive Capital leads $20M investment in Brazilian healthcare startup Pipo Saude

Pipo Saude, a startup that developed a platform that sells and manages healthcare benefits for Brazilian companies, has raised $20 million in a Series A round of funding.

Joshua Kushner’s Thrive Capital led the round, marking the first time the New York-based venture firm has led an investment in a Brazilian startup. (Although, notably, Thrive has also put money in Nubank and Loft.)

Atlantico participated in the financing as a new investor in addition to all existing backers including Monashees, Kaszek and OneVC. Nubank co-founder and CEO David Velez and Cedar co-founder and CEO Florian Otto (and former CEO of Groupon in Brazil) also joined in the round. Pipo Saude had raised $4.6 million in a seed round in June 2020 that was led by Monashees and Kaszek with the participation of OneVC and Nubank’s Velez.

Manoela Mitchell (CEO), Thiago Torres (COO) and Vinicius Correa (CTO) founded Pipo Saude in July 2019 with the goal of “bringing an unparalleled experience” of buying and managing healthcare benefits for corporations in combination with providing a care navigation platform for employees. More simply, its mission is to “transform” the healthcare experience for companies and their employees.

Pipo Saude started selling its solution six months after its inception. Over the past year, it has grown its ARR by “around 5x,” and the number of lives managed by 7.2x, according to Mitchell. Pipo currently has 100 corporate clients and 15,000 lives under management. Its clients include Brazilian unicorns MadeiraMadeira and Buser, Caelum and Funcional Health Tech, among others. Pipo Saude makes money off of commissions and says that its business model is a hybrid of Nava, Accolade and Rightway, but that Zenefits and Amino are inspirations or benchmarks that it “looks up to.”

When Pipo was first founded in 2019, the company was trying to convince prospective customers that digital healthcare could be an interesting option to reduce cost and improve care, according to Mitchell.

And then when the COVID-19 pandemic hit in March 2020, she added, the whole sector was forced to change and the company saw all stakeholders from doctors to employers to patients “adopting technologies to make their job easier or more accessible to others.”

This trend also helped Pipo grow. In January 2020, it had two corporate clients. By December of the same year, it had around 70.

“COVID has fast-forwarded the digital transformation of the healthcare system everywhere, but even more so in a place like Brazil that was a few years behind the U.S. when it came to technology penetration in the health space,” Mitchell said.

Image Credits: Pipo Saude

Because healthcare is so complex, most companies outsource the benefits capabilities to traditional brokers. Pipo, she said, was created to “disrupt this landscape” with the use of technology and data.

The company claims that enrolling a new member in a healthcare plan can typically take up to 10 business days in Brazil, but that Pipo “can do it in less than 1 hour” given its integrations with HMO/PPOs. It plans to use the new funds to continue investing heavily in technology and data with the goal of launching its first digital product that will be “100% focused” on its members.

Sao Paulo-based Pipo currently has 108 employees distributed across 33 cities and three countries, up from 27 a year ago. During the pandemic, it evolved into being a “remote-first-company.”

The startup also plans to use its new capital to do some hiring, with the goal of doubling the number of its full-time employees by year’s end. Mitchell described the business model as an “asset-light” one that connects healthcare buyers, users and products without having any type of regulatory capital need.

In the medium to long term, Mitchell said the team views Pipo as a local business rather than a global one.

“Going deep into healthcare data and protocols requires a lot of specialization and deep understanding,” she said. Also, the opportunity in Brazil is just so large.

“We are focused on being the local leader in Brazil rather than having a broader but shallower expertise across many markets,” Mitchell said.

Kareem Zaki, a general partner at Thrive, said his firm invested in Pipo Saude because it viewed the company as the first of its kind innovating the channel by which healthcare solutions reach individuals and their families.

“Pipo is using data to deliver value at every step of the customer journey, from informing employers’ purchase decisions and automating manual pieces of benefit management to helping employees navigate the healthcare system to meet their individual needs,” he wrote in an email. “The result is 20% better savings, up to 50 times faster workflows, and a 97% customer satisfaction rate that is unprecedented in the industry.”

Pipo Saude is not the only Brazilian startup tackling the benefits space. Earlier this month, Flash, a startup that has developed a flexible benefits platform for Brazilian companies and employees, announced it had raised $22 million in a Series B round of funding led by Tiger Global Management.

#brazil, #david-velez, #digital-healthcare, #funding, #fundings-exits, #health, #healthcare, #healthtech, #pipo-saude, #recent-funding, #saas, #startups, #tc, #thrive, #thrive-capital, #venture-capital

NewView Capital leads $22.3M Series B in Australian telehealth platform Eucalyptus

Telehealth platform Eucalyptus raised a $22.3 million Series B round of funding to build a digital health portfolio for primary care in Australia.

NewView Capital led the round with participation from existing investors Blackbird Ventures and W23, and new investor AirTree Ventures. As part of the investment, Ravi Viswanathan, NewView founder and managing partner, will be joining the Eucalyptus board.

The new round gives the Sydney-based company a total of $32.8 million raised since it was founded in 2019 by Tim Doyle, Benny Kleist, Alexey Mitko and Charlie Gearside.

Australia’s healthcare system is a two-payer model, where most of the care is paid for by the government, and there is a smaller insurance coverage that is owned by individuals. Eucalyptus fits into these models as a private-pay option selling directly to consumers. In some cases, the company is able to charge lower copays for care than the average $25 per doctor visit, Doyle told TechCrunch.

He touts the company as the “largest vertically integrated telehealth platform in Australia,” serving more than 200,000 patients across four demographic-focused brands: contraception and fertility, skincare, men’s health and sexual wellness. Each brand has its own core platform of healthcare providers, patient data repository, remote monitoring tools and partnerships with pathology labs and pharmacies.

All of that results in a higher touch and higher quality relationship between doctor and patient, Doyle said.

“We are seeing an opportunity to shorten the amount of time between identification of a condition and diagnosis,” he added. “We also want to go more in-depth into diabetes, heart conditions and mental health. People are dropping out of diabetes and mental care because there are not enough touch points that are easy to use. If we can build a hub, it will make it easier to treat those conditions.”

In addition to product development, the new funding enables Eucalyptus to build toward being a major player in the telehealth industry. The company will introduce new brands in the next year around chronic care like behavioral health, weight management and diabetes.

Eucalyptus grew its revenue between 200% to 300% year over year since 2019, Doyle said. This is not unlike other startups in the digital health sector, where 2020 saw another record year for venture capital investment. He expects similar growth in 2021, including adding about 20 employees to be over 100 by the end of the year.

Meanwhile, Doyle said he is excited to work with NewView, especially with Viswanathan and associate Christina Fa, who said Eucalyptus is proving that Australia can lead in digital healthcare.

“The team is impressive in terms of clarity of vision and execution, especially in the way they brought in people to manage the brands,” she told TechCrunch. “It is unique being based in Australia where they don’t have the Teledocs and other digital health companies. Instead, Eucalyptus had to build all of that in-house and do the hard work upfront. In addition, they curated a network of health providers and four brands, each with their own personalities that can be fully vertically integrated and own the customer journey.”

 

#airtree-ventures, #blackbird-ventures, #christina-fa, #digital-healthcare, #eucalyptus, #health, #newview-capital, #ravi-viswanathan, #recent-funding, #startups, #tc, #telehealth, #telemedicine, #tim-doyle

Kry closes $312M Series D after use of its telehealth tools grows 100% yoy

Swedish digital health startup Kry, which offers a telehealth service (and software tools) to connect clinicians with patients for remote consultations, last raised just before the pandemic hit in Western Europe, netting a €140M Series C in January 2020.

Today it’s announcing an oversubscribed sequel: The Series D raise clocks in at $312M (€262M) and will be used to keep stepping on the growth gas in the region.

Investors in this latest round for the 2015-founded startup are a mix of old and new backers: The Series D is led by CPP Investments (aka, the Canadian Pension Plan Investment Board) and Fidelity Management & Research LLC, with participation from existing investors including The Ontario Teachers’ Pension Plan, as well as European-based VC firms Index Ventures, Accel, Creandum and Project A.

The need for people to socially distance during the coronavirus pandemic has given obvious uplift to the telehealth category, accelerating the rate of adoption of digital health tools that enable remote consultations by both patients and clinicians. Kry quickly stepped in to offer a free service for doctors to conduct web-based consultations last year, saying at the time that it felt a huge responsibility to help.

That agility in a time of public health crisis has clearly paid off. Kry’s year-over-year growth in 2020 was 100% — meaning that the ~1.6M digital doctors appointments it had served up a year ago now exceed 3M. Some 6,000 clinicians are also now using its telehealth platform and software tools. (It doesn’t break out registered patient numbers).

Yet co-founder and CEO, Johannes Schildt, says that, in some ways, it’s been a rather quiet 12 months for healthcare demand.

Sure the pandemic has driven specific demand, related to COVID-19 — including around testing for the disease (a service Kry offers in some of its markets) — but he says national lockdowns and coronavirus concerns have also dampened some of the usual demand for healthcare. So he’s confident that the 100% growth rate Kry has seen amid the COVID-19 public health crisis is just a taster of what’s to come — as healthcare provision shifts toward more digital delivery.

“Obviously we have been on the right side of a global pandemic. And if you look back the mega trend was obviously there long before the pandemic but the pandemic has accelerated the trend and it has served us and the industry well in terms of anchoring what we do. It’s now very well anchored across the globe — that telemedicine and digital healthcare is a crucial part of the healthcare systems moving forward,” Schildt tells TechCrunch.

“Demand has been increasing during the year, most obviously, but if you look at the broader picture of healthcare delivery — in most European markets — you actually have healthcare usage at an all time low. Because a lot of people are not as sick anymore given that you have tight restrictions. So it’s this rather strange dynamic. If you look at healthcare usage in general it’s actually at an all time low. But telemedicine is on an upward trend and we are operating on higher volumes… than we did before. And that is great, and we have been hiring a lot of great clinicians and been shipping a lot of great tools for clinicians to make the shift to digital.”

The free version of Kry’s tools for clinicians generated “big uplift” for the business, per Schildt, but he’s more excited about the wider service delivery shifts that are happening as the pandemic has accelerated uptake of digital health tools.

“For me the biggest thing has been that [telemedicine is] now very well established, it’s well anchored… There is still a different level of maturity between different European markets. Even [at the time of Kry’s Series C round last year] telemedicine was maybe not something that was a given — for us it’s always been of course; for me it’s always been crystal clear that this is the way of the future; it’s a necessity, you need to shift a lot of the healthcare delivery to digital. We just need to get there.”

The shift to digital is a necessary one, Schildt argues, in order to widen access to (inevitably) limited healthcare resources vs ever growing demand (current pandemic lockdown dampeners excepted). This is why Kry’s focus has always been on solving inefficiencies in healthcare delivery.

It seeks to do that in a variety of ways — including by offering support tools for clinicians working in public healthcare systems (for example, more than 60% of all the GPs in the UK market, where most healthcare is delivered via the taxpayer-funded NHS, is using Kry’s tools, per Schildt); as well as (in a few markets) running a full healthcare service itself where it combines telemedicine with a network of physical clinics where users can go when they need to be examined in person by a clinician. It also has partnerships with private healthcare providers in Europe.

In short, Kry is agnostic about how it helps deliver healthcare. That philosophy extends to the tech side — meaning video consultations are just one component of its telemedicine business which offers remote consultations for a range of medical issues, including infections, skin conditions, stomach problems and psychological disorders. (Obviously not every issue can be treated remotely but at the primary care level there are plenty of doctor-patient visits that don’t need to take place in person.)

Kry’s product roadmap — which is getting an investment boost with this new funding — involves expanding its patient-facing app to offer more digitally delivered treatments, such as Internet Cognitive Based Therapy (ICBT) and mental health self-assessment tools. It also plans to invest in digital healthcare tools to support chronic healthcare conditions — whether by developing more digital treatments itself (either by digitizing existing, proven treatments or coming up with novel approaches), and/or expanding its capabilities via acquisitions and strategic partnerships, according to Schildt.

Over the past five+ years, a growing number of startups have been digitizing proven treatment programs, such as for disorders like insomnia and anxiety, or musculoskeletal and chronic conditions that might otherwise require accessing a physiotherapist in person. Options for partners for Kry to work with on expanding its platform are certainly plentiful — although it’s developed the ICBT programs in house so isn’t afraid to tackle the digital treatment side itself.

“Given that we are in the fourth round of this massive change and transition in healthcare it makes a lot of sense for us to continue to invest in great tools for clinicians to deliver high quality care at great efficiency and deepening the experience from the patient side so we can continue to help even more people,” says Schildt.

“A lot of what we do we do is through video and text but that’s just one part of it. Now we’re investing a lot in our mental health plans and doing ICBT treatment plans. We’re going deeper into chronic treatments. We have great tools for clinicians to deliver high quality care at scale. Both digitally and physically because our platform supports both of it. And we have put a lot of effort during this year to link together our digital healthcare delivery with our physical healthcare delivery that we sometimes run ourselves and we sometimes do in partnerships. So the video itself is just one piece of the puzzle. And for us it’s always been about making sure we saw this from the end consumer’s perspective, from the patient’s perspective.”

“I’m a patient myself and still a lot of what we do is driven by my own frustration on how inefficient the system is structured in some areas,” he adds. “You do have a lot of great clinicians out there but there’s truly a lack of patient focus and in a lot of European markets there’s a clear access problem. And that has always been our starting point — how can we make sure that we solve this in a better way for the patients? And then obviously that involves us both building strong tools and front ends for patients so they can easily access care and manage their health, be pro-active about their health. It also involves us building great tools for clinicians that they can operate and work within — and there we’re putting way more effort as well.

“A lot of clinicians are using our tools to deliver digital care — not only clinicians that we run ourselves but ones we’re partnering with. So we do a lot of it in partnerships. And then also, given that we are a European provider, it involves us partnering with both public and private payers to make sure that the end consumer can actually access care.”

Another batch of startups in the digital healthcare delivery space talk a big game about ‘democratizing’ access to healthcare with the help of AI-fuelled triage or even diagnosis chatbots — with the idea that these tools can replace at least some of the work done by human doctors. The loudest on that front is probably Babylon Health.

Kry, by contrast, has avoided flashy AI hype, even though its tools do frequently incorporate machine learning technology, per Schildt. It also doesn’t offer a diagnosis chatbot. The reason for its different emphasis comes back to the choice of problem to focus on: Inefficiencies in healthcare delivery — with Schildt arguing that decision-making by doctors isn’t anywhere near the top of the list of service pain-points in the sector.

“We’re obviously using what would be considered AI or machine learning tools in all products that we’re building. I think sometimes personally I’m a bit annoyed at companies screaming and shouting about the technology itself and less about what problem you are solving with it,” he tells us. “On the decision-support [front], we don’t have the same sort of chatbot system that some other companies do, no. It’s obviously something that we could build really effortlessly. But I think — for me — it’s always about asking yourself what is the problem that you’re solving for? For the patient. And to be honest I don’t find it very useful.

“In many cases, especially in primary care, you have two categories. You have patients that already know why they need help, because you have a urinary tract infection; you had it before. You have an eye infection. You have a rash —  you know that it’s a rash, you need to see someone, you need to get help. Or you’re worried about your symptoms and you’re not really sure what it is — and you need comfort. And I think we’re not there yet where a chatbot would give you that sort of comfort, if this is something severe or not. You still want to talk to a human being. So I think it’s of limited use.

“Then on the decision side of it — sort of making sure that clinicians are making better decisions — we are obviously doing decision support for our clinicians. But if it’s one thing clinicians are really good at it’s actually making decisions. And if you look into the inefficiencies in healthcare the decision-making process is not the inefficiency. The matching side is an inefficiency side.”

He gives the example of how much the Swedish healthcare system spends on translators (circa €200M) as a “huge inefficiency” that could be reduced simply — by smarter matching of multilingual clinicians to patients.

“Most of our doctors are bilingual but they’re not there at the same time as the patient. So on the matching side you have a lot of inefficiency — and that’s where we have spent time on, for example. How can we sort that, how can we make sure that a patient that is seeking help with us ends up with the right level of care? If that is someone that speaks your native language so you can actually understand each other. Is this something that could be fully treated by a nurse? Or should it be directly to a psychologist?”

“With all technology it’s always about how do we use technology to solve a real problem, it’s less about the technology itself,” he adds.

Another ‘inefficiency’ that can affect healthcare provision in Europe relates to a problematic incentive to try to shrink costs (and, if it’s private healthcare, maximize an insurer’s profits) by making it harder for patients to access primary medical care — whether through complicated claims processes or by offering a bare minimum of information and support to access services (or indeed limiting appointment availability), making patients do the legwork of tracking down a relevant professional for their particular complaint and obtaining a coveted slot to see them.

It’s a maddening dynamic in a sector that should be focused on making as many people as healthy as they possibly can be in order that they avoid as much disease as possible — obviously as that outcome is better for the patients themselves. But also given the costs involved in treating really sick people (medical and societal). A wide range of chronic conditions, from type 2 diabetes to lower back pain, can be particularly costly to treat and yet may be entirely preventable with the right interventions.

Schildt sees a key role for digital healthcare tools to drive a much needed shift toward the kind of preventative healthcare that would be better all round, for both patients and for healthcare costs.

“That annoys me a lot,” he says. “That’s sometimes how healthcare systems are structured because it’s just costly for them to deliver healthcare so they try to make it as hard as possible for people to access healthcare — which is an absurdity and also one of the reasons why you now have increasing costs in healthcare systems in general, it’s exactly that. Because you have a lack of access in the first point of contact, with primary care. And what happens is you do have a spillover effect to secondary care.

“We see that in the data in all European markets. You have people ending up in emergency rooms that should have been treated in primary care but they can’t access primary care because there’s no access — you don’t know how to get in there, it’s long waiting times, it’s just triaged to different levels without getting any help and you have people with urinary tract infections ending up in emergency rooms. It’s super costly… when you have healthcare systems trying to fend people off. That’s not the right way doing it. You have to — and I think we will be able to play a crucial role in that in the coming ten years — push the whole system into being more preventative and proactive and access is a key part of that.

“We want to make it very, very simple for the patients — that they should be able to reach out to us and we will direct you to the right level of care.”

With so much still to do tackling the challenges of healthcare delivery in Europe, Kry isn’t in a hurry to expand its services geographically. Its main markets are Sweden, Norway, France, Germany and the UK, where it operates a healthcare service itself (not necessarily nationwide), though it notes that it offers a video consultation service to 30 regional markets.

“Right now we are very European focused,” says Schildt, when asked whether it has any plans for a U.S. launch. “I would never say that we would never go outside of Europe but for here and now we are extremely focused on Europe, we know those markets very, very well. We know how to manoeuvre in the European systems.

“It’s a very different payer infrastructure in Europe vs the US and then it’s also so that focus is always king and Europe is the mega market. Healthcare is 10% of the GDP in all European markets, we don’t have to go outside of Europe to build a very big business. But for the time being I think it makes a lot of sense for us to stay focused.”

 

#accel, #artificial-intelligence, #canadian-pension-plan-investment-board, #covid-19, #digital-health, #digital-healthcare, #europe, #fundings-exits, #germany, #health, #healthcare, #johannes-schildt, #kry, #machine-learning, #machine-learning-technology, #national-health-service, #nhs, #sweden, #tc, #telehealth, #telemedicine

In a sign of digital health’s rise, Livongo and Teladoc Health agree to $18.5 billion merger

In a sign of the growing importance and value of digital healthcare in the world of medicine, two of the industry’s publicly traded companies have agreed to a whopping $18.5 billion merger.

The union of Teladoc Health, a provider of virtual care services, and Livongo, which has made a name for itself by integrating hardware and software to monitor and manage chronic conditions like diabetes, will create a giant in the emerging field of telemedicine and virtual care.

“By expanding the reach of Livongo’s pioneering Applied Health Signals platform and building on Teladoc Health’s end-to-end virtual care platform, we’ll empower more people to live better and healthier lives,” said Glen Tullman, Livongo Founder and Executive Chairman. “This transaction recognizes Livongo’s significant progress and will enable Livongo shareholders to benefit from long-term upside as the combined company is positioned to serve an even larger addressable market with a truly unmatched offering.”

Under the terms of the agreement, each share of Livongo will be exchanged for 0.5920 shares of Teladoc health plus a cash payment of $11.33 for each share. The deal, based on Teladoc’s closing price on August 4, 2020, is roughly $18.5 billion. It’s an eye-popping figure for a company that was, at one point, trading below $16 per-share.

But the new reality of healthcare delivery in the era of COVID-19 rapidly accelerated the adoption of digital and remote care services like those Livongo was selling to its customers — and investor came calling as a result.

The combined company is expected to have pro forma revenue of $1.3 billion representing 85 percent year on year growth, on a pro forma basis. For 2020, the combined company expects adjusted EBITDA to reach $120 million.

“This merger firmly establishes Teladoc Health at the forefront of the next-generation of healthcare,” said Jason Gorevic, the chief executive officer of Teladoc Health, in a statement. “Livongo is a world-class innovator we deeply admire and has demonstrated success improving the lives of people living with chronic conditions. Together, we will further transform the healthcare experience from preventive care to the most complex cases, bringing ‘whole person’ health to consumers and greater value to our clients and shareholders as a result.”

The companies emphasized their combined ability to engage with patients and monitor and manage their conditions using technology. Teladoc Health’s flywheel approach to continued member engagement combined with Livongo’s proven track record of using data science to build consumer trust will accelerate the combined company’s development of longitudinal consumer and provider relationships, the companies said in a statement.

Teladoc currently counts 70 million customers in the United States with an access to Medicare and Medicaid patients that Livongo’s services could reach. The combined company also pitched the operational efficiencies that could be created through the merger. Teladoc estimated that there would be “revenue synergies” of $100 million two years from the close of the deal, reaching $500 million on a run rate basis by 2025, according to a statement. 

Gorevic will run the combined company and David Snow will serve as the chair of the new board — which will be comprised of eight current Teladoc board members and five members of the Livongo board.

The company expects the deal to close by the end of the fourth quarter, subject to regulatory approvals. Lazard advised Teladoc on the transaction while Morgan Stanley served as the financial advisor to Livongo. 

#articles, #chair, #chief-executive-officer, #diabetes, #digital-healthcare, #financial-advisor, #health, #healthcare, #lazard, #livongo, #medicare, #morgan-stanley, #tc, #technology, #telehealth, #telemedicine, #united-states

Using population health analysis to improve patient care brings Sema4 a $1.1 billion valuation

Sema4, the Stamford, Conn.-based digital healthcare company now worth just over $1 billion, takes its name from the system of sending messages via code.

And like its namesake, Sema4 is trying to send messages of its own to the broader healthcare system based on the signals it uncovers in massive datasets of population health that can reveal insights and best practices, according to the company’s founding chief executive, Eric Schadt.

Spun out from the Mt. Sinai Health System in June 2017, Sema4 is the second digital healthcare company in a week to reach a billion dollar valuation from investors (Ro, too, is now worth over $1 billion). In this case, Sema4’s $121 million financing came from BlackRock, Deerfield and Moore Capital, and follows only twelve months after another $120 million institutional financing from investors including Blackstone, Section 32, Oak HC/FT, Decheng, and the Connecticut Innovation Fund.

The company’s ability to attract capital may have something to do with a business model that’s managed to amass nearly 10 million patient records through partnerships with ten major health systems and several hundred thousand more patients through a strategy that has the company offer direct insights to patients as part of enhanced care services.

“My effort centered on… how do we aggregate bigger and bigger sources of data to better inform patients around their health and wellness,” said Schadt. 

Sema4 chief executive Eric Shcadt. Image Credit: Sema4

Sema4 works with physicians to provide analysis of genetic data so doctors can make informed decisions on what care would work best with their patients. “We’re providing a meaningful service on behalf of the physician and it’s a service that the physician wants us to do because they’re generally not adept at the genomics,” said Schadt. 

The company provides screening services for reproductive health and oncology as two of its core competencies, acting as a single point of care to collect and store information in a way that’s easily portable for patients, Schadt said

“We play in the testing arena as a growth hack engine to engage patients and generating high amounts of quality data and seek to engage with them to get to higher scales to build the biggest models to get what [doctors] need on any condition of interest,” he said. 

Sema4 is currently working in three areas, reproductive health, precision oncology, and now COVID-19. In April, the company had no ability to analyze tests for COVID-19, but did have lab space that was certified to perform the necessary analysis. Now, the company can handle15,000 tests per day.

As a result of the round, Andrew Elbardissi, a managing partner at Deerfield, as joined Sema4’s board of directors. Other recent additions to the board include Mike Pellini, the former chief executive of Foundation Medicine and current investor at Section32 (the venture firm launched by former Google Ventures head Bill Maris); former principal deputy commissioner of the Food and Drug Administration, Rachel Sherman; and former Goldman Sachs chief financial officer, Marty Chavez. 

“Sema4 is a leader at the forefront of one of the most exciting intersections in healthcare – the application of technology, AI and machine learning to help improve patient outcomes. We are excited to support this talented management team as Sema4 begins its next phase of growth,” said Will Abacassis, Managing Director at BlackRock, in a statement. 

Goldman Sachs acted as a financial advisor to Sema4 on the transaction.

 

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Digital elective care and telemedicine provider Ro raises $200 million at a reported $1.5 billion valuation

In three years Zachariah Reitano’s startup, Ro, has managed to hit a reported $1.5 billion valuation for its transformation from a company focused on treating erectile disfunction to a telemedicine service for a range of elective and urgent care-focused treatments.

Through Rory for women’s health, Roman for men’s health, and Zero for smoking cessation, Reitano’s company now treats 20 conditions including sexual health, weight loss, dermatology, allergies and more, according to a statement from the company.

Image Credit: Zero

Ro also has a new pharmacy business, Ro Pharmacy, which is an online cash pay pharmacy offering over 500 generic medications for just $5 per month per drug. And the company is getting into the weight loss business through a partnership with the private equity-backed health care company, Gelesis.

Ro’s also becoming a gateway into patient acquisition for primary care providers through Ribbon Health, and a test-case for the use of Pfizer’s Greenstone service, which provides certification that a generic drug is validated by one of the major pharmaceuticals.

The company’s $1.5 billion valuation is courtesy of a new $200 million investment from existing investors led by General Catalyst and including FirstMark Capital, Torch, SignalFire, TQ Ventures, Initialized Capital, 3L, and BoxGroup. New first time investor The Chernin Group also participated. In all, Ro has raised $376 million since it launched in 2017.

“This new investment will further our mission to become every patient’s first call. We’ll continue to invest in our vertically-integrated healthcare ecosystem, from our Collaborative Care Center to our national pharmacy operating system. This is just the beginning of Ro’s patient-centered healthcare platform.” 

It’s all part of the company’s mission to provide a point of entry into the healthcare system independent of insurance qualifications.

“Telehealth companies like Ro are using technology to address long-standing healthcare disparities that have been exacerbated by Covid-19,” said Dr. Joycelyn Elders, MD, Ro Medical Advisor and Former US Surgeon General. “By empowering providers to leverage their skills as efficiently and effectively as possible, Ro delivers affordable, high-quality care regardless of a patient’s location, insurance status, or physical access to physicians and pharmacies.”

Ro’s new financing is one of several forays by tech investors into reshaping the healthcare system at a time when patient care has been severely disrupted by attempts to mitigate the spread of COVID-19.

Digital medicine is assuming a central position in the healthcare world with most consultations now occurring online. Reimbursement schemes for telemedicine have changed dramatically and investors see an opportunity to capitalize on these changes by aggressively backing the expansion plans of companies looking to bring digital healthcare directly to consumers.

That’s one of the reasons why Ro’s major competitor, Hims, is reported to be seeking access to public markets through its sale to a Special Purpose Acquisition Company for roughly $1 billion, according to Reuters.

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Can API vendors solve healthcare’s data woes?

A functioning healthcare system depends on caregivers having the right data at the right time to make the right decision about what course of treatment a patient needs.

In the aftermath of the COVID-19 epidemic and the acceleration of the consumer adoption of telemedicine, along with the fragmentation of care to a number of different low-cost providers, access to a patient’s medical records to get an accurate picture of their health becomes even more important.

Opening access to developers also could unlock new, integrated services that could give consumers a better window into their own health and consumer product companies opportunities to develop new tools to improve health.

While hospitals, urgent care facilities and health systems have stored patient records electronically for years thanks to laws passed under the Clinton administration, those records were difficult for patients themselves to access. The way the system has been historically structured has made it nearly impossible for an individual to access their entire medical history.

It’s a huge impediment to ensuring that patients receive the best care they possibly can, and until now it’s been a boulder that companies have long tried to roll uphill, only to have it roll over them.

Now, new regulations are requiring that the developers of electronic health records can’t obstruct interoperability and access by applications. Those new rules may unlock a wave of new digital services.

At least that’s what companies like the New York-based startup Particle Health are hoping to see. The startup was founded by a former emergency medical technician and consultant, Troy Bannister, and longtime software engineer for companies like Palantir and Google, Dan Horbatt.

Particle Health is stepping into the breach with an API -based solution that borrows heavily from the work that Plaid and Stripe have done in the world of financial services. It’s a gambit that’s receiving support from investors including Menlo Ventures, Startup Health, Collaborative Fund, Story Ventures and Company Ventures, as well as angel investors from the leadership of Flatiron Health, Clover Health, Plaid, Petal and Hometeam.

Image via Getty Images / OstapenkoOlena

“My first reaction when I met Troy, and he was describing what they’re doing, was that it couldn’t be done,” said Greg Yap, a partner with Menlo Ventures, who leads the firm’s life sciences investments. “We’ve understood how much of a challenge and how much of a tax the lack of easy portability of data puts on the healthcare system, but the problem has always felt like there are so many obstacles that it is too difficult to solve.”

What convinced Yap’s firm, Menlo Ventures, and the company’s other backers, was an ability to provide both data portability and privacy in a way that put patients’ choice at the center of how data is used and accessed, the investor said.

“[A service] has to be portable for it to be useful, but it has to be private for it to be well-used,” says Yap. 

The company isn’t the first business to raise money for a data integration service. Last year, Redox, a Madison, Wis.-based developer of API services for hospitals, raised $33 million in a later-stage round of funding. Meanwhile, Innovaccer, another API developer, has raised more than $100 million from investors for its own take.

Each of these companies is solving a different problem that the information silos in the medical industry presents, according to Patterson. “Their integrations are focused one-to-one on hospitals,” he said. Application developers can use Redox’s services to gain access to medical records from a particular hospital network, he explained. Whereas using Particle Health’s technology, developers can get access to an entire network.

“They get contracts and agreements with the hospitals. We go up the food chain and get contracts with the [electronic medical records],” said Patterson.

One of the things that’s given Particle Health a greater degree of freedom to acquire and integrate with existing healthcare systems is the passage of the 21st Century Cures Act in 2016. That law required that the providers of electronic medical records like Cerner and EPIC had to remove any roadblocks that would keep patient data siloed. Another is the Trusted Exchange Framework and Common Agreement, which was just enacted in the past month.

“We don’t like betting on companies that require a change in law to become successful,” said Yap of the circumstances surrounding Particle’s ability to leapfrog well-funded competitors. But the opportunity to finance a company that could solve a core problem in digital healthcare was too compelling.

“What we’re really saying is that consumers should have access to their medical records,” he said.

Isometric Healthcare and technology concept banner. Medical exams and online consultation concept. Medicine. Vector illustration

This access can make consumer wearables more useful by potentially linking them — and the health data they collect — with clinical data used by physicians to actually make care and treatment decisions. Most devices today are not clinically recognized and don’t have any real integration into the healthcare system. Access to better data could change that on both sides.

“Digital health application might be far more effective if it can take into context information in the medical record today,” said Yap. “That’s one example where the patient will get much greater impact from the digital health applications if the digital health applications can access all of the information that the medical system collected.” 

With the investment, which values Particle Health at roughly $48 million, Bannister and his team are looking to move aggressively into more areas of digital healthcare services.

“Right now, we’re focusing on telemedicine,” said Bannister. “We’re moving into the payer space… As it stands today we’re really servicing the third parties that need the records. Our core belief is that patients want control of their data but they don’t want the stewardship.”

The company’s reach is impressive. Bannister estimates that Particle Health can hit somewhere between 250 and 300 million of the patient records that have been generated in the U.S. “We have more or less solved the fragmentation problem. We have one API that can pull information from almost everywhere.”

So far, Particle Health has eight live contracts with telemedicine and virtual health companies using its API, which have pulled 1.4 million patient records to date.

The way it works right now, when you give them permission to access your data it’s for a very specific purpose of use… they can only use it for that one thing. Let’s say you were using a telemedicine service. I allow this doctor to view my records for the purpose of treatment only. After that we have built a way for you to revoke access after the point,” Bannister said.

Particle Health’s peers in the world of API development also see the power in better, more open access to data. “A lot of money has been spent and a lot of blood and sweat went into putting [electronic medical records] out there,” said Innovaccer chief digital officer Mike Sutten.

The former chief technology officer of Kaiser Permanente, Sutten knows healthcare technology. “The next decade is about ‘let’s take advantage of all of this data.’ Let’s give back to physicians and give them access to all that data and think about the consumers and the patients,” Sutten said.

Innovaccer is angling to provide its own tools to centralize data for physicians and consumers. “The less friction there is in getting that data extracted, the more benefit we can provide to consumers and clinicians,” said Sutten.

Already, Particle Health is thinking about ways its API can help application developers create tools to help with the management of COVID-19 populations and potentially finding ways to ease the current lockdowns in place due to the disease’s outbreak.

“If you’ve had an antibody test or PCR test in the past… we should have access to that data and we should be able to provide that data at scale,” said Bannister. 

“There’s probably other risk-indicating factors that could at least help triage or clear groups as well… has this person been quarantined has this person been to the hospital in the past month or two… things like that can help bridge the gap,” between the definitive solution of universal testing and the lack of testing capacity to make that a reality, he said. 

“We’re definitely working on these public health initiatives,” Bannister said. Soon, the company’s technology — and other services like it — could be working behind the scenes in private healthcare initiatives from some of the nation’s biggest companies as software finally begins to take bigger bites out of the consumer health industry.

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Kry launches free service for doctors to do video consultations during COVID-19 crisis

Swedish telehealth startup Kry has launched a tool for healthcare professionals to conduct remote consultations during the coronavirus pandemic. Calls for EU citizens to self isolate to reduce the spread of COVID-19 is driving major demand for video appointments, it said.

The platform — Care Connect by Kry — is launching in Europe, with ten languages supported initially, but will shortly be opening up worldwide. CEO and co-founder, Johannes Schildt, told us it’ll be launching in North America within a matter of “days”. 

Last week US regulators relaxed rules around the use of telehealth platforms for delivering a broader range of healthcare services — opening up the market for remote consultations during the coronavirus crisis.

“We are working extremely hard at all levels because this is time critical,” said Schildt. “We want to get this out there as soon as we possibly can. Today we’re launching it in Europe, we’re aiming to have it available within days in the US and Canada.”

The web-based platform for healthcare professionals to carry out encrypted video consultations does not require a Kry account. Instead doctors sign up (and in) with an email address and are able to send a one-time SMS link to a patient’s mobile phone number — which the patient then clicks on to begin a video consultation with the doctor from their smartphone.

Kry says the clinician’s email will never be shared with the patient. 

“We have been doing this for a long time but now it’s more important than ever that you have as many as possible of the current consultations now happening in physical locations are moved to digital,” said Schildt. “It’s for all clinicians, for anyone that’s run their own practice — to enable them to move their consultations to video in an easy way.”

He said Kry has seen demand for its commercial video-chat-with-a-doctor roughly doubling in recent weeks as Europeans seek alternatives for accessing primary care during the coronavirus crisis.   

“We’ve seen a big increase in demand… from patients. But a lot of that is also not driven by COVID-19 specific things — it’s everything else,” he told TechCrunch. “Obviously you have a new virus that is spreading but you also have a lack of access to GP practices and traditional healthcare — because a lot of traditional primary care is closing down. So you still have a lot of people that have urinary track infections, eye infections, skin conditions and other things that we can help with.

“So we see a big uplift in all symptoms. What’s also very encouraging to see is that we see a big uplift in older patients… understanding the benefits of digital healthcare. Usually when we’re launching in new markets the first cohort is the young and slightly more tech savvy population.”

Schildt said Kry is recruiting clinicians “all across Europe” to cope with increased demand. 

“We’re getting a lot of senior, retired clinicians,” he told us. “We’re unlocking a lot of underused talent so we now have a lot of retired doctors joining and helping out. And they should obviously not be in an intensive care unit or at the primary healthcare center where they risk getting the disease because they are old and might be fragile but they’re usually very, very senior doctors. 

“We’re also getting a lot of doctors who are on parental leave or part time sick leave and so on. So it’s a massive exercise for us now across all our European markets.”

The 2015-founded startup has served up some 1.6 million digital doctors appointments across Europe at this stage. It said it will offer training to doctors signing up to Care Connect on how to carry out remote consultations — given many may be doing so for the first time.

While the intent with Care Connect is to support heavily burdened public healthcare services during the coronavirus pandemic, there’s clearly scope for Kry to turn the platform into an additional revenue-generating service in future — once some of the doctors it onboards now for free have become comfortable using it.

Although Schildt emphasizes that’s not why they’ve scrambled to get the product out there right now. 

“We’re building this because we feel a huge responsibility to help out,” he said. “I think that everybody has a responsibility to help out. And what we can do of course in the market that we’re in we are working super hard on all levels and we’re working very closely with different governments in the markets that we’re in — but this is also a way for us to help out in the markets where we currently don’t have our own medical staff.

“So this is a solution that could be helpful in Spain, Italy, and in other markets around the globe.”

Kry has more products to help fight COVID-19 in the pipeline — and has already launched a symptom-checker for the disease within its existing apps for patients (aka Kry, or Livi) in all its European markets. It’s also doing some home-monitoring partnerships for patients who are in quarantine, per Schildt.

He won’t be drawn on what else it’s working on — noting it’s “working very closely with some of the European governments”. “In some of those cases they have specifically asked us not to be specific about what we’re doing,” he said. 

Asked about how else it’s using symptom data generated by use of its services, he said it’s sharing aggregated data with existing paying customers, such as the UK’s National Health Service (NHS).

He also told us European governments are keen to get access to data that might help them track how the coronavirus is spreading.

“Obviously this is really interesting data — at an aggregated level — as we can see where you have symptoms starting to spread. And obviously as a big partner to some of the largest payers of healthcare in the world — [e.g.] European governments — we are monitoring this very closely together with them,” said Schildt.

“We can see in real time, more or less, where you have different symptoms that are trending — and we already, before you had the big COVID-19 outbreak, you could see that viral infections and upper respiratory infections started to trend in a bit unusual way compared to last year. And that data we’re also sharing with our main [healthcare customers, including the UK’s NHS] to help their staff understand demand.”

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