StartUp Health Magazine 2021 Q2 by StartUp Health

ISSUE 06

Sheena Franklin takes on culturallycompetent skin health page 8

STARTUPHEALTH.COM HEALTHMOONSHOTS.COM

Meet the Health Transformers -StartUp Health Annual Vintage Updates -2021 Midyear Insights Report -Health Transformers in the News startuphealth.com

THE BEST WAY TO PREDICT THE FUTURE IS TO CREATE IT. -ALAN KAY Chief Scientist at Atari

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FOUNDERS’ LETTER

Impossible Is a State of Mind

If we would have said 18 months ago, before COVID, that two relatively young startups would be responsible for one of the world’s most significant and life saving vaccines, and that vaccine would be made available within a year, we would have been laughed out of the room. Did we mention that the vaccine would also involve an unprecedented level of collaboration between business competitors? Ridiculous. Nelson Mandela famously put it this way: “It always seems impossible until it’s done.” We take that quote – and the incredible vaccine achievements of the last year – personally because we’ve met our share of doubters. Over the past decade, when presenting our ambitious vision and strategic plan for achievOur mission thrives ing health moonshots, most people told us we were dreaming the impossible. They told us we couldn't because of people like you. If help billions of people live healthier lives while also you know other like-minded investors or entrepreneurs, generating healthy financial returns. we’d love to meet them. But extraordinary times call for a transformative approach. We are seeing significant signals across our global portfolio telling us that health innovation is moving faster than most ever imagined. For proof, look no further than the fact that health innovation funding is set to double in 2021 (read our Insights report on page 56). To support and accelerate that progress, on April 1, 2021, we officially launched our third fund, The StartUp Health Moonshots Impact Fund, as a unique, quarterly memberdriven rolling fund. We are deeply grateful to the dozens of investors who have already subscribed, and continue with us on our journey to achieve Health Moonshots. We have already made nine investments in Q2, and in the following pages you’ll meet some of these new “Health Transformers” and learn about the impact they’re making. Thank you for your ongoing support. Together we can improve the health and wellbeing of everyone in the world. Join the mission at healthmoonshots.com.

Steven Krein CEO, Co-founder & Managing Partner

Unity Stoakes President, Co-founder & Managing Partner startuphealth.com

EDITOR’S LETTER

Purpose Meets Progress

This is a magazine about progress. Some days it feels like healthcare will never change, like we’re stuck in a Groundhog Day time loop where every morning looks the same. But we believe – and this magazine bears witness to the fact – that with the right mindset, progress is not only possible, it’s unstoppable. And we're not just talking about baby steps, but leapfrog progress in every corner of the world. Did you know that health innovation funding has seen a 20-fold increase globally in the last decade? Change is afoot! (Read the full 2021 Midyear Insights Report on page 56). It’s easy to miss the signals in all the noise, which is why we’ve updated StartUp Health Magazine with a new look and feel, and a new quarterly frequency. It still has the same heart, to share stories of health moonshot progress. As always, we invite you to come and meet the inspiring entrepreneurs and innovators who are rethinking what’s possible in health. People like Sharud Agarwal, founder of Akute Health (story on page 24) who, after battling cancer and struggling with confusing patient records, designed a more patientcentric EMR. Then there's Sheena Franklin, the founder of K’ept Health who graces our cover. Franklin identified a race problem in dermatology and set out to level the playing field with her tele-derm platform (story on page 8). In these pages you’ll also find news to keep tabs on the StartUp Health portfolio, like how WayForward was acquired by Dario Health [Nasdaq: DRIO], how Nightingale Health IPO'd on the Nasdaq Helsinki (read more on page 50) and how more than 20 StartUp Health portfolio companies raised institutional rounds. By their nature, health moonshots are lofty goals. They force us to raise our gaze skyward to consider them, to plan a path forward. Yet it is in the ordinary work of hard-working entrepreneurs that we make ongoing progress towards these audacious goals. And that is what the stories in these pages are all about. The impossible made real. We hope you’re as inspired by these Health Transformers, and their impact, as we are.

Logan Plaster Editor-in-Chief

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In This Issue 3 Founders' Letter 4 Editor's Letter 6 Meet the Newest Health Transformers 8 K'ept Health 12 New Frontier Mobile Diagnostics 16 Unpluq 20 Array Analytics 24 Akute Health 28 Televëda 32 One Stop Wellness 36 Canopie 40 Prospr Health 44 Health Transformers in the News 50 StartUp Health News 50 Nightingale IPOs on NASDAQ Helsinki 52 The Health Moonshot Impact Fund 56 StartUp Health Insights 2021 Midyear Funding Report 70 StartUp Health Investments by Vintage

EDITOR-IN-CHIEF Logan Plaster // DEPUTY EDITOR Jennifer Hankin CONTRIBUTING EDITORS India Edwards / Nicole Kinsey COVER ILLUSTRATION Lauren Crow startuphealth.com

Meet the newest

Health Transformers On the following pages, we'll introduce you to the inspiring founders we invested in this quarter. Their work addresses a range of health moonshots, from Access to Care to Healthy Longevity & Aging, and challenges legacy thinking in everything from dermatology to electronic health records. To learn how you can back Health Transformers, go to healthmoonshots.com

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K'EPT HEALTH

NEW FRONTIER MOBILE DIAGNOSTICS

UNPLUQ

ARRAY ANALYTICS

AKUTE HEALTH

TELEVËDA

ONE STOP WELLNESS

CANOPIE

PROSPR HEALTH

startuphealth.com

HEALTH TRANSFORMER Sheena Franklin, CEO & Founder 8kepthealth@startuphealth.com StartUp Health Magazine / Issue 6

MEET THE HEALTH TRANSFORMERS

K'ept Health Is Upgrading Tele-Dermatology With a Platform That Understands Skin Tones Dermatology education has a skin color problem. Textbooks have an overrepresentation of white skin, resulting in sub-par care for people of color. Sheena Franklin (pictured) is changing that equation with a holistic, culturally-competent, AI-driven skin health platform.

ACCESS TO CARE MOONSHOT VINTAGE: 2021/Q2 KEPT.HEALTH

The world of dermatology is undergoing a massive transformation. Direct-to-consumer dermatology businesses and improvements in phone cameras are speeding up access to virtual skin scans. Artificial intelligence is making the analysis of those photos faster and more accurate, and telemedicine is enabling dermatologists to speak with patients in faraway places, making geography no longer a barrier to access. But with all of these advancements, dermatology still faces a glaring challenge. Ironically, it’s a skin color challenge. You see, like so much of medicine, the specialty of dermatology was originally designed by white doctors focusing on white skin. As a result, there’s a lack of skin color representation and training in dermatology educa-

tion. According to one study done at the University of Pennsylvania, the percentage of images of dark skin in dermatology textbooks ranged from 4% to 18%. That lack of skin color training has real health impacts. In a story published by Stat News, dermatologists reported that a lack of images is one reason why many conditions like cancer and Lyme disease go misdiagnosed in darker-skinned patients. According to The Skin Cancer Foundation, the five-year melanoma survival rate for Black patients is just 70% compared with 94% for white patients. Cultural competency is a phrase that gets thrown around a lot in fields like psychiatry and counseling, but it’s just as relevant in the hard sciences like dermatology. K’ept Health, under the leadership startuphealth.com

MEET THE HEALTH TRANSFORMERS

of CEO and Founder Sheena Franklin, is tackling this challenge head-on, while also creating a wrap-around health experience with skin health at the center. origin story

Before she founded K’ept Health, Sheena Franklin worked as a healthcare lobbyist for 20 years, which gave her a framework for how the business of healthcare works nationally. While working as a lobbyist at Walgreens she worked with their innovation team, where she was able to observe day-to-day healthcare delivery up close. But Franklin wasn’t just an observer — she was a patient. She suffered from a severe skin condition. But as knowledgeable as her work experience made her, she still struggled to find a dermatologist who could help her. This, she realized, was due in part to her melanin-rich skin and the systemic gaps in dermatology. The result was that doctors didn’t spend time to find the internal root cause of her skin issues. She knew that novel technologies like highresolution cameras and AI were disrupting dermatology, but from her vantage point, there wasn’t equal access to those advance-

ments. So Franklin went on a listening tour. She talked to other women — particularly women of color — about their skin concerns, and their experiences with the world of dermatology. What she found was a common thread that became the spark for a new approach to skin health. She decided to build a data-driven app and culturally competent integrative health platform to increase access to the best in dermatology care. under the hood

When patients first sign onto the K’ept Health platform, they have the opportunity to take a self-guided at-home facial skin analysis to identify any skin concerns. The platform assesses their skin health virtually, plus patients are able to track their skin’s progress visually over time. The most common skin conditions K’ept treats are acne, hyperpigmentation, melasma, eczema, and psoriasis, among others. Patients can also have a virtual visit with a dermatologist or chat online with a medical esthetician to ask any questions about their skincare routine or triage needed

Melanin-Aware Skin Health Terms to Know

Hyperpigmentation Characterized by having some patches of skin that are darker than others

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Melasma A condition in which brown patches appear on the face

Melanin A brownish-black pigment found in skin, hair, and other animal or plant tissues

Psoriasis A chronic skin disease characterized by scaly, reddish patches

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Eczema A noncontagious skin disorder of unknown cause, characterized by inflammation, itching, and the formation of scales Rosacea A chronic form of acne affecting the nose, forehead, and cheeks, characterized by red pustular lesions

care. Each user then receives a suggested treatment plan, which can include anything from topical products to nutrition tips, and, if needed, prescriptions can be sent directly to a pharmacy of choice. This is a vetted workforce where K’ept has put a premium on partnering with practitioners who are experts in skin of color and integrative dermatology. K’ept Health uses artificial intelligence to “tag” images of skin with notes including skin condition, shape, size, biomarkers, and more. The key difference here, however, is that this tagging intentionally takes into account differences in skin color and population. No more having AI weighted towards a predominately white catalog of skin images. That means more care options and greater accuracy, but also simply means that under-represented patients feel seen and understood. why we're proud to invest

Sheena Franklin brings to K’ept a unique understanding of policy and innovation. But just as important to her health moonshot vision is her personal passion drawn from her experience with a painful skin condition. Franklin’s not just trying to solve a problem in a hot market segment; she’s dedicated to helping people just like herself. That passion has driven her to do the hard legwork to prove her thesis — such as partnering with leading universities and skin-of-color clinics to proactively and responsibly collect data and validate their artificial intelligence. We’re also excited to back Sheena Franklin and her team at K’ept Health because they’re innovating at the intersection of

Just as important to her health moonshot vision is Franklin's personal passion drawn from her experience with a painful skin condition. Franklin’s not just trying to solve a problem in a hot market segment; she’s dedicated to helping people just like herself.

two critical areas. On one hand, they’re part of a broader movement to completely revamp dermatology and skincare in a way that blows open access to care. The advent of teledermatology means that people at risk of skin cancer or whose internal health issues are overlooked will get the expert scans they need much sooner, which will save lives. We need startups like K’ept to keep pushing in this direction. But just as important as innovating in dermatology writ large is the rethinking of healthcare access based on skin color. K’ept Health is essential to health innovation because they’re challenging the medical education establishment and showing that access to care isn’t just about whether you can physically get to an appointment and afford it. Franklin and her team are exposing that healthcare access is also about racial representation. K’ept is at the front edge of a movement for more culturally competent healthcare, and we can’t wait to see where they take it next. 4 KEPTHEALTH@STARTUPHEALTH.COM startuphealth.com 11

HEALTH TRANSFORMERS Jeff Blackwood, CEO & Co-founder Michael Davolt, Co-founder newfrontiermd@startuphealth.com 12 StartUp Health Magazine / Issue 6

MEET THE HEALTH TRANSFORMERS

New Frontier Mobile Diagnostics Is Using Just-in-Time Logistics to Open Access to Medical Imaging Two previous StartUp Health portfolio company founders – Jeff Blackwood (pictured) and Michael Davolt – teamed up to bring high-quality medical imaging to underserved populations. Now they’re back in the StartUp Health family.

ACCESS TO CARE MOONSHOT VINTAGE: 2021/Q2 NEWFRONTIERMD.COM

Many people take diagnostic imaging for granted. If you visit a modern ER or get admitted to a hospital, your doctor will have quick access to things like X-ray and ultrasound to identify what’s happening beneath the skin. It turns out that these tests, which can feel so basic, have an outsized effect on our health. Diagnostic imaging is often the first “look” at what may be causing a patient’s condition. According to the WHO, diagnostic imaging can answer between 70% and 80% of diagnostic questions. And yet access to these services continues to lag. As many as two-thirds of the world’s population has no access to diagnostic imaging technology. In the United States, we see this gap in rural and low-income

regions. According to Becker’s Healthcare, one in five Americans — around 60 million — “live in rural areas and depend on their local hospitals for care.” Last year, 20 of those hospitals closed, the most closures we’ve ever seen in a single year. One answer to the hospital closure problem has been the rise of outpatient imaging centers. But these facilities can be crowded and often require the patient to drive a long distance. They also suffer from some of the same overhead problems as hospitals, where facility fees drive up the cost of what should be simple, low-cost procedures. Diagnostic imaging is essential to health and relatively simple to provide. What if new business models and tech-enabled logistics could democratize these services and bring on-demand diagnostic testing startuphealth.com 13

MEET THE HEALTH TRANSFORMERS

to everyone? Meet New Frontier Mobile Diagnostics, a startup making this vision a reality. origin story

In the early 2000s, Jeff Blackwood was living in Kansas City and working a corporate job as an executive sales manager. He was proud of what he’d accomplished in business, but he wanted more. “I really wanted something meaningful to come out of what I was doing,” says Blackwood. So he enrolled in an MBA focused on entrepreneurship. During the program, he met Michael Davolt, and a mutual respect quickly formed. “You’re drawn to competent people,” says Blackwood, recalling those early meetings. “You can tell when someone is an innovator and can get things done.” A seed was planted then that would take many years, and a career shift, to bring to fruition. After the program, Davolt went on to co-found a senior care startup called Caremerge, which joined StartUp Health in 2013. Blackwood left the corporate world to start his own health tech endeavor, Pathfinder Health Innovations, a behavioral health platform that helps autism therapists. With the encouragement of Davolt, Blackwood brought Pathfinder into the StartUp Health community as well. The two kept the conversations going for years until each exited from their business. That opened the door to a new greenfield conversation about what they could accomplish if they finally combined forces. Over the years, Davolt had operated a trucking logistics company, and so the 14 StartUp Health Magazine / Issue 6

two entrepreneurs decided to explore how tech-enabled logistics could radically open up access to healthcare services in underserved communities. They settled on expanding access to diagnostic imaging and New Frontier was born. under the hood

The core concept behind New Frontier is simple. Instead of sending patients to a hospital or an imaging center for an ultrasound, those services are brought to the patient, on-demand. Take, for instance, the case of a senior care facility, where many such calls originate. This particular center has a registered nurse on site who decides that the patient before him would benefit from an echocardiogram to assess his heart health. Instead of sending the patient 45 minutes away to a crowded imaging center that will charge high facility fees, the RN sends the order to New Frontier, who immediately dispatches a technician. The ultrasound tech arrives carrying a state-of-the-art ultrasound device in the equivalent of a laptop case and is able to conduct the study quickly, wherever the patient is most comfortable. Best yet, the costs are predictable and affordable. “People are used to a certain run-around when it comes to diagnostic imaging,” says Blackwood. “When they hear that our services are inexpensive enough that they can pay in cash, they’re thrilled.” New Frontier provides its services in doctor’s offices, clinics, and care facilities, covering cardiac, vascular, and general imaging. They use portable imaging machines developed by GE, providing much of the same functionality and quality that are

available in a hospital setting. In addition, New Frontier supports these machines through a cloud-based PACS, providing physicians access to patient images at any time. What’s interesting about New Frontier is that the imaging technology isn’t new. Mobile ultrasound has been available practically for decades, in some form or another, though it gets more portable every year. What’s innovative is how Blackwood and his team are using new tech-enabled logistics to make those services available to more people. New Frontier operates a bit like Uber or Lyft, using a tech platform to route imaging techs to the right place in the most efficient way possible. These are logistics capabilities that have revolutionized other industries, and now they have a chance to democratize medical imaging. Currently, New Frontier is focused on providing ultrasound imaging, but the company plans to add digital X-ray within the year. why we're proud to invest

As tempting as it can be to get excited about shiny new toys in health tech — and we certainly do — often the highestimpact innovation is much less flashy. It turns out that to achieve health moonshots and bring high-quality care to all people, we have to be just as innovative with our business models and infrastructure as we are with our gadgets and gizmos. That’s the beauty of New Frontier. Blackwood and his team have taken incredibly powerful tools that already exist on the market, but have been under-utilized, and used technology to make those services more avail-

Two previous StartUp Health portfolio company founders teamed up to bring high-quality medical imaging to underserved populations. Now they’re back in the StartUp Health family.

able. That’s a receipt for a quick and lasting impact. We’re also bullish on New Frontier because their health moonshot vision goes beyond rural America, and way beyond ultrasound. The ethos and mindset behind New Frontier is what connects all underserved communities with the services that they need to live a healthy life. Finally, bringing New Frontier into the StartUp Health fold is particularly meaningful for us because we’re welcoming back familiar faces. As we often say, once a Health Transformer, always a Health Transformer. We had a front-row seat as Blackwood and Davolt built Pathfinder and Caremerge, respectively. During that time we encouraged a spirit of openness and collaboration, and the fact that these two founders would not only team up but bring their newest company back into the StartUp Health family brings all of those lessons full circle. We can’t wait to see what they build next. 4 NEWFRONTIERMD@STARTUPHEALTH.COM startuphealth.com 15

MEET THE HEALTH TRANSFORMERS

HEALTH TRANSFORMERS Jorn Rigter, Co-founder (R) Tim Smits, Co-founder (L) unpluq@startuphealth.com

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Unpluq, the Dutch Startup Helping People Beat Smartphone Addiction Jorn Rigter and Tim Smits have created a USB “key” that helps smartphone users turn off distractions and make more conscious choices about their time.

MENTAL HEALTH & HAPPINESS MOONSHOT VINTAGE: 2021/Q2 UNPLUQ.COM

Over the last decade, we’ve seen a rapid evolution in how we use smartphones. When we first gained the ability to use apps like Facebook and Tinder on the go, it was a fun novelty. Every little “bing” notification was a new connection being made, or a moment to be shared with friends. But these apps and games became more sophisticated. By studying our behavior, they became so good at grabbing and holding our attention that the balance of power shifted. The likes, the memes, the contro-

startuphealth.com 17

MEET THE HEALTH TRANSFORMERS

versy — they all become perfectly dialed to keep us logged in and scrolling. Most of us have had the experience of falling down the rabbit hole, swiping and tapping until we finally emerge, dazed and wondering how the last 30 minutes disappeared. This unconscious scrolling hurts our productivity. Studies show that when you get a notification “ping” that breaks you out of a flow state, it can take as long as 25 minutes to get back in the groove. It also hurts our sleep. A study in the journal Sleep Medicine showed that the more time adolescents spent on screen-based activities, the less sleep they got during the night. These sleep issues were linked with increased symptoms of insomnia and depression. The list goes on. Smartphone users are finally saying enough is enough. They want back control of their time and attention. In fact, 57% of all people want to reduce their smartphone use, according to a study by Bank My Cell. They’ve realized that endless checking and scrolling on ever-present smartphone apps often hinders our work and makes us less happy. Thankfully, startups like Unpluq are finding novel ways to address the problem. origin story

Jorn Rigter and Tim Smits met during orientation week at the University of Delft in The Netherlands. The two 18-year-old industrial design students were put into a peer mentor group together and they immediately hit it off. One day, while they were studying together, the two realized how distracted they were by their phones. It bothered 18 StartUp Health Magazine / Issue 6

them deeply that their unconscious behavior of looking at apps and responding to notifications was robbing them of study time and getting them to do things that frankly they didn’t want to do. “Often, what would happen is that I’d get my phone to check the weather, then I’d see a notification, and before I knew it, I’d been scrolling on Facebook for 20 minutes,” Rigter recalls. As they dug deeper into the issue, they saw how pervasive it was in the student body around them, and how the effects went way beyond time management. “Losing productivity is only one part of the problem,” says Rigter. “The bigger issue is the real effect that social media and dating apps have on our mental wellbeing. People are spending their time in a way they don’t want to, which makes them less happy. We want to give them their time back. Give them control back.” Together, the two students began to design a combination of software and hardware that would help people change their smartphone habits and become more intentional about their time. A few years, and many prototypes later, that idea became Unpluq, and they’ve been growing rapidly ever since.

under the hood

why we're proud to invest

Unpluq consists of an app and a bright yellow USB key that plugs into the phone. Within the app, users designate two modes, a normal mode where all apps are accessible, and a distraction-free mode where certain apps are hidden, including all notifications. In order to operate in the normal mode and access what they’ve deemed the “distracting” apps, the user has to plug in the yellow USB key. The physical Unpluq “key” is critical. There are many apps on the market designed to help people stay focused and ignore distractions, but they can be bypassed with a few clicks. Having to plug in a physical key in order to access certain apps helps rewire the brain. “What’s working really well is that the action of plugging in the key is making the behavior conscious,” says Rigter. The user is empowered to make intentional decisions about where that key is kept and how and when it is accessed. Imagine, for instance, making the choice to leave your Unpluq key at home while you take a walk in the woods or attend your child’s piano recital. Once that choice has been made, your mind is freed to focus fully on the moment before you. Early results are positive: Unpluq users spend an average of 69 minutes less per day on their smartphones. Currently, Unpluq is only available on Android, since the platform is open source and allows for app block, but the team is hard at work on an iPhone version.

There are a lot of reasons to be excited about what co-founders Jorn Rigter, Tim Smits, and Harrison Burch are building. For one, they’re tapping into a generational moment. Young people — many of whom were practically born with smartphones in their hands — are deciding they want more out of their lives than to be slaves to app notifications. As evidence, after Unpluq launched on Kickstarter in 2020, they sold more than 800 keys in a few months without spending a dime on marketing. We’re also excited because Unpluq is tapping into a massive, growing market. To start, Rigter and his team are targeting 126 million millennials in Europe and the United States who want to reduce their smartphone usage. The startup is also poised to partner with corporations directly. In the United States alone it’s estimated that lost productivity due to distractions costs a combined $650 billion. Then there are the parents seeking to encourage balance as their children use smartphones — another $797M market. Finally, we’re proud to support the Unpluq team because they have a health moonshot mentality that goes way beyond “productivity.” For Rigter, the Unpluq key — and all of the wraparound content and services that they provide — is about helping an entire generation take control of their lives. This isn’t about restriction, it’s about gaining the freedom to make better choices and become happier humans. That’s a mission we can get behind. 4 UNPLUQ@STARTUPHEALTH.COM

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HEALTH TRANSFORMERS Carl Davis, CEO & Co-founder Fady Barmada, President & Co-founder arrayanalytics@startuphealth.com 20 StartUp Health Magazine / Issue 6

MEET THE HEALTH TRANSFORMERS

Array Analytics Is Combining Health Data With Geo-Mapping to Open Up Access to Care A team of healthcare architects and designers have built a new way to rapidly assess healthcare trends, in order to help hospitals anticipate — and build for — the needs of tomorrow.

ACCESS TO CARE MOONSHOT VINTAGE: 2021/Q2 ARRAY-ANALYTICS.IO

Hospitals and healthcare organizations have the complicated task of meeting the needs of today’s patients while also planning for the patients of the future. An emergency department, as an example, might be operating at 75% capacity today, but because of factors in the community could be at 150% capacity a year from now. Unless they want to start diverting patients elsewhere, the hospital needs to anticipate, not just react, to the dynamic forces around them. Traditionally, hospitals have worked with consultants to analyze and understand a patient’s journey through their network. Using this data, hospitals would make their best guesses about future needs,

and then invest millions in new buildings, recruiting new talent, and investing in new technology. If there’s one thing that the COVID-19 pandemic taught us, it’s that future forecasting has severe limitations. No one predicted how quickly the pandemic would flip healthcare delivery on its head. It emptied out emergency departments, put surgeries on hold for months, and turned telemedicine from a nice-to-have to an absolute must-have. It proved that change can happen in healthcare at a pace we never thought possible. One health design consultancy saw this shift in the industry — the speed of change and the lack of dynamic data — and decided to do something about it. startuphealth.com 21

MEET THE HEALTH TRANSFORMERS

origin story

Carl Davis recruited Fady Barmada to join his healthcare design consultancy, called Array Architects, six years ago. For 35 years, Davis had embraced design thinking to drive value to healthcare customers. The approach involved asking “better, human-centered questions,” says Barmada. Then came a project that changed everything. Array was hired by a renowned cancer institute to create a “master plan.” They were to start by collecting data to create a “current state” of the organization, then, taking into account the many strands of information that impact the organization, create a plan for future growth and expansion. “We spent a year and a half working with this organization,” says Barmada. “We dug deep and did great work. But it turned out that hard work didn’t matter because we were using old, standard methods for analyzing analytics. The data we were using to create a future plan was static and therefore immediately out of date.” The result was that the organization was unable to anticipate infrastructure needs, which led to an inability to recruit top talent, which led to a degradation of overall patient care. As proud as he was of the work they’d delivered, Barmada considered it a failure. This “failure” was a bolt of lightning for the two collaborators, who realized that in such a rapidly changing healthcare environment, they needed methods and tools that were far more flexible and helped organizations anticipate change. They looked everywhere for a tech platform that would help them gather data more quickly and 22 StartUp Health Magazine / Issue 6

make real-time decisions, and to develop multiple scenarios quickly. When they didn’t find it, they knew they had to build it themselves. Array Analytics was born. under the hood

Array Analytics’ core product is a platform called Pivotal. In order to address the dynamic nature of healthcare, Davis and Barmada knew they’d need to condense the initial data gathering experience — the process that used to stretch over a year. So they partnered with Optum Analytics, one of the largest health information and research firms, and built a patient claimsbased platform that can dial up health data in minutes rather than months. But the having the data is just the beginning. Unlike other analytics platforms and dashboards, and there are many, Pivotal is a GIS platform — a geospatial information system. That means that the mountains of claims data they pull in from many disparate sources are geo-tagged, allowing a kind of analysis that wasn’t possible before. “Our framework for gathering, managing, and analyzing data is rooted in the science of geography and space,” says Barmada. “This spatially aware approach to problem-solving that’s rooted in our experience as architects and designers is one of our big differentiators.” This new kind of analysis, which combines health data science with mapping technology, allows users to look at their data in eye-opening ways, slicing and dicing patient behaviors, competitor behaviors, and patient preferences. That allows them to rapidly run scenarios, test hypotheses, and build new business models without

taking on excessive risk. At the end of the day, says Barmada, Array Analytics still has architecture in its blood. They believe they’re ultimately in the business of building spaces. They’re giving the health system the data required to create the spaces — physical and virtual — that are needed to provide the best care possible. “The more risk we can take out of these decisions, the more resources that will be available for higher-quality clinical care,” says Davis. why we're proud to invest

To accomplish uncommon things, we need uncommon perspectives. In the 1960s, NASA turned to Playtex, the bra maker, and Goodyear, the tire company, to create a spacesuit that could safely purvey a human to the moon. With their background in architecture and design, the team at Array Analytics brings this kind of fresh perspective to healthcare. To radically open up access to care, we can’t look at the same data in the same way as we did in the past. Array’s unique approach to geo-mapping is one exciting way to open up what’s possible. We’re also privileged to back Davis and Barmada because their multi-factorial approach to health analytics could have a real impact on social determinants of health (SDOH). By mapping patient behavior along with hospital throughput, Array can help health organizations spot “healthcare deserts” and allocate resources accordingly. “The future vision,” says Barmada, “is to be able to use AI/ML over this geo-coded data that automatically identifies patient

To accomplish uncommon things, we need uncommon perspectives. Co-founder Fady Barmada (above) uses his experience in architecture and design to think differently about healthcare delivery.

care gaps. By identifying and predicting patient care gaps, health systems can be proactive rather than reactive in meeting their community care needs. After all, he adds, agility isn’t just about how fast you can react. It’s about anticipating what will come next. As we’ve written in the past, more health data isn’t better data. It’s how we use data to direct resources where they’re needed most that really moves the needle. Platforms like Pivotal, by Array Analytics, hold this exciting potential, and we’re proud to be part of that journey. 4 ARRAYANALYTICS@STARTUPHEALTH.COM startuphealth.com 23

MEET THE HEALTH TRANSFORMERS

HEALTH TRANSFORMER Sharud Agarwal, CEO & Founder akutehealth@startuphealth.com

Akute Health Is the EHR Designed for Asynchronous Medicine After battling cancer, software developer Sharud Agarwal decided to build a better electronic health record, one that powers “membership medicine” and treats patients and doctors as the true end users.

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ACCESS TO CARE MOONSHOT VINTAGE: 2021/Q2 AKUTEHEALTH.COM

Over the last couple decades, we’ve seen the infrastructure of patient data undergo a sea change. First we upgraded patient records from paper to digital. Then we used those systems to triple down on the ability to gather data, creating a body of data so “big” a whole industry had to emerge just to manage it. Today, doctors have access to everything – prescription data, lab data, patient history. But rarely is that information delivered to the doctor in a way that is clear and actionable. Instead, over the years, electronic health records (EHR) evolved based on economic drivers. Because of the hospital’s bottom-line need to bill fully and accurately for services, big EHRs like Epic and Cerner became more and more like billing platforms, and less like a platform for doctors and patients to understand and share critical information. In fact, according to Sharud Agarwal, the CEO and founder of Akute Health, EHRs don’t treat the doctor and patient as end users at all. That designation belongs to the hospital and the insurance company. Case in point. When a patient suffering from a chronic disease wants to know their current health metrics, they might be handed a stack of print-outs containing ALL of their numbers, even if only one number matters. Want to know how that number is trending over time – which is 10 times more useful than a single data point – good luck. You’ll have to do that math manually. But these two examples barely scratch the surface of how today’s EHRs fail to treat patients and providers as end users.

There’s the lack of API integration, forcing people to move between platforms like zendesk, slack and the EHR. There’s the lack of mobile interfaces, making it nearly impossible to communicate on the fly. And there’s the inability to capture and bill for asynchronous healthcare. Of course, for anyone in healthcare today, this will sound like preaching to the choir. These are legacy problems. The more interesting topic is, who’s willing and able to build a better EHR? origin story

In 2014, Sharud Agarwal was just another student graduating from the University of Texas with a degree in computer engineering. But less than a year later, his world and identity would shift. Rather than launch into a successful software development career (he scored a job at Qualcomm right out of school), he found out he had cancer and would need to manage his health full time if he wanted to survive. But for the ever-curious Agarwal, this turned out to be less of a detour, and more the next phase of his education. “You learn way more about healthcare than you want to when you’re diagnosed with cancer,” he says with a disarming laugh. “At the time I didn’t understand how insurance worked or anything.” Over the course of his patient journey, he saw dozens of doctors, reviewed medical charts and monitored his own health trends. What he discovered was that the tech infrastructure behind his patient data was a broken mess. For instance, he noted that his health record was designed around the idea of billing for distinct “encounters”.

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MEET THE HEALTH TRANSFORMERS

“If I email my doctor, is that an encounter?” says Agarwal. “That would suck for me if I got billed for that.” Typically, they don’t, he discovered, but that means that doctors end up operating outside of the chart, using text and email that never gets integrated into the patient record. His second lesson was that the data infrastructure behind his care was, as he puts it, “terrible.” He’d carry a giant binder with his records around with him as he saw doctor after doctor. This was both frustrating and unhelpful. To solve this problem – and to fill his time lying in hospital beds – he built an iOS app to track his own medical records. These lessons, that frustration, might have remained just that if it hadn’t been for a phone call he received. Agarwal’s department chair from UT, who he’d interacted with just a few times, called him up out of the blue and asked him how he was doing. Agarwal was moved, and they struck up a relationship. Later, when it looked like Agarwal was going to beat his diagnosis, the professor posed a question: What’s next? They talked about the problems he’d witnessed in patient data, the app he’d built, and his passion for putting patients at the center of the data conversation. “Through his questions he pushed me to realize that I was actually onto something.” With the need so tangible, and the patient record app serving as a beta, Agarwal founded Akute Health in 2018. His professor at UT helped connect him to the university medical center where he was able to dive even deeper into health data infrastructure and learn what was broken and what wasn’t. Then it was off to the races. 26 StartUp Health Magazine / Issue 6

Agarwal is sparking and supporting a movement of alternative care models. He wants to power a kind of healthcare that isn’t built around insurance claims, but is structured around a trusted doctor-patient relationship.

under the hood

For anyone in the corporate world today, Akute Health will look pleasantly familiar. You see, Agarwal grew up with SAAS platforms like Slack, Calendly and Twilio. He couldn’t imagine why doctors, patients, and developers would accept less than what these platforms (some of which are free) offered to the world. So he baked all of that functionality into one patient data platform, under a HIPAA-compliant umbrella. Akute Health follows the SAAS model of being cloud based – unlike most EHRs today – so it’s accessible on any device. Patients can schedule appointments like they’re using Calendly and have it integrate with their Google Calendar. Physicians can prescribe medications, order labs or send a fax. There’s a built-in task manager that helps users assign tasks and track progress. Every feature works as well on mobile as on a desktop, which, according to Agarwal, is a surprising differentiator. “I’m absolutely shocked that other

EMRs don’t work on your phone,” says Agarwal. “I can’t believe I still have to point this out as a feature in 2021. But it is.” Some competitors offer app or web access for mobile, but the functionality is often limited to “read only.” Beyond the basic functionality, which early testers have described as gloriously user-friendly, Akute bakes in one important element that has shaped its business model. Every interaction between provider and patient is given equal value in the chart. Whether it’s a text, an email, a video check-up or an in-person visit, it’s seamlessly integrated into one provider-patient relationship. What that means is that Akute Health isn’t built for healthcare facilities who want to stick to the legacy way of tracking “patient encounters.” Akute is enabling a new care paradigm where patients are cared for, and billed, more holistically. We’re seeing this more and more with Direct Primary Care (DPC) clinics, which bill members monthly rather than by encounter. That said, as Akute gains momentum in these innovative markets, legacy players are taking note. The tide is shifting towards true asynchronous care, and when it does, there will need to be a software infrastructure to support it. why we're proud to invest

Agarwal’s vision is a big one. He’s disrupting a Electronic Health Record market that includes the likes of Epic, Cerner and McKesson. But it’s even bigger than that. With Akute Health, Agarwal is sparking and supporting a movement of alternative care models. He wants to power a kind of

healthcare that isn’t built around insurance claims, but is structured around a trusted doctor-patient relationship. In this, Agarwal is in good company. He follows a trend in the market of tech-enabled asynchronous clinics like OneMedical, Forward and Cityblock. That’s an awesome health moonshot vision that we can get behind. There’s a lot more here to be excited about. Akute is leveraging a full-stack software approach that we’ve seen succeed in other markets. It’s prioritizing trust and transparency over insurance claims. It supports continuous monitoring and true preventive health. Akute Health is an enabling technology. It lowers the barrier to entry for an entrepreneur that wants to create a new way of caring for patients. Whether they’re creating the next virtual-first clinic or a clinic dedicated to a rare disease, Akute Health makes the EHR process simple and comprehensive. Finally, we’re bullish on Akute Health – which was just accepted into Y Combinator’s upcoming batch – because it’s not just trying to improve on today’s broken EHRs. Sharud Agarwal is young enough and personally motivated enough to take on the seemingly impossible task of disrupting how healthcare gets delivered, using patient records as the entry point. The company is poised to be a critical piece of a “membership medicine” movement that could improve the health of millions, opening up access to care while lowering overall costs. We can’t wait to see what they do next. 4 AKUTEHEALTH@STARTUPHEALTH.COM

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HEALTH TRANSFORMERS Shruti Gurudanti, CEO & Co-founder Mayank Mishra, CTO & Co-founder televeda@startuphealth.com 28 StartUp Health Magazine / Issue 6

MEET THE HEALTH TRANSFORMERS

Televëda Is the Virtual Platform Keeping Lonely Seniors Engaged Shruti Gurudanti (pictured) and Mayank Mishra work with hospital systems and senior centers to reduce social isolation in older adults by building and supporting virtual communities. HEALTHY LONGEVITY & AGING VINTAGE: 2021/Q2 TELEVEDA.COM

Social isolation is considered one of the most significant health risks in older adults and costs roughly $6.7 billion annually. According to the Centers for Disease Control and Prevention, more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated. In one study, social isolation was also associated with about a 50% increased risk of dementia and other serious medical conditions. Some solutions have hit the market that can help combat senior isolation, like the way the company Papa pairs older adults and families with “Papa Pals” for assistance with everyday tasks. But these task-based programs don’t address a deeper need for community. In the face of this deeper loneliness challenge, the answer has too often been to turn to a screen for entertainment.

But studies have shown that excessive TV watching can speed cognitive decline in the elderly, and watching YouTube does nothing to build community. Many seniors find community on Facebook groups. Synthesio reported that 41% of Facebook users are 65+. Furthermore, Pew Research states that the share of older Americans who use the platform has more than doubled since August 2012. But according to this article, many adult Facebook users in the U.S. lack a clear understanding of how the platform works. “Around half of these users say they do not understand why certain posts are included in their news feed and others are not, including 20% who say they do not understand this at all,” the article reads. Although there are millions of older adults on Facebook, its endlessly changing algorithm makes it difficult to control what pops up on your timeline and who to connect with. startuphealth.com 29

MEET THE HEALTH TRANSFORMERS

Thankfully, that’s changing due to platforms like Televëda. “Our whole mission is community and making sure that the seniors are happy and they’re bonding,” says Mayank Mishra, Chief Technology Officer at the startup Televëda, which joined StartUp Health in 2021. origin story

For Shruti Gurudanti, senior loneliness hit close to home. She witnessed her grandfather become homebound and then decline quickly because he wasn’t able to interact with others. His battle with isolation was what sparked a realization in Gurudanti: loneliness and social isolation in older adults are massive healthcare problems, not merely inconveniences. As a lawyer at one of the largest law firms in India, handling big multi-national crossborder M&A transactions and leading strategies for brands like Sephora, Louis Vuitton, and Christian Dior, Gurudanti wasn’t initially familiar with the digital health space. But, after the tragic passing of her grandfather, she felt it was up to her to help mend this gap in senior care. So, she teamed up with another likeminded individual who was also passionate about senior care — former law classmate and self-taught software engineer Mayank Mishra — and founded Televëda. This two-way interactive social engagement platform for adults 65+ helps senior organizations effectively engage elders experiencing isolation through live social experiences delivered within the comfort of the home.

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under the hood

When Gurudanti and Mishra created the Televëda platform, ease of use was a primary goal. Once a community center adopts Televëda, they have all of the tools they need for their community’s engagement under one white-labeled platform. Here’s how it works. When a community center adopts the Televëda platform, their members fill out a one-time registration form to create their own secure profiles — no username and password required. Feel free to call Televëda’s toll-free number, send them a quick email, or simply chat with an agent if you need assistance. Within a couple of clicks, members gain access to an intelligent virtual lobby where they can join live happy hours, sign up for any of the 25+ classes like nutrition workshops, medicare 101, tech-time, bingo, and art, or even host their own gathering. And the best part? All of the community members are around the same age. Televëda’s simple interface makes it remarkably easy for tech-shy audiences (especially seniors) to navigate and empowers them to form connections and stay engaged through interactive live streaming experiences. Their comprehensive, readyto-go activity programs save organizations hours of planning and preparation time every month and are certain to increase engagement, mood scores, and happiness levels in members. “We want to help providers with that virtual hybrid infrastructure,” Mishra explains. “Loneliness is considered a touchyfeely subject. But it has a lot of correlation with early mortality and other healthcare

This two-way interactive social engagement platform for adults 65+ helps senior organizations effectively engage elders experiencing isolation through live social experiences.

issues. By focusing on getting people engaged — even if it’s just a fun bingo class where they know they can meet their friends, I think that will have a big impact on individuals and society in general.” Televëda makes it easy for seniors to find their own circle of like-minded individuals with dozens of in-person and virtual activities so that everyone can have a wonderfully inclusive community experience. why we’re proud to invest

Shruti Gurudanti’s tragic experience of losing her grandfather and Mayank Mishra’s passion for senior care created in them a burning commitment to solving a problem for older adults everywhere. StartUp Health is keen on investing in Health Transformers who are addressing underlying issues in healthcare, and Gurudanti and Mishra are the kinds of individuals we need to make it happen.

As more people live longer, we need the ability to scale senior care in a way that addresses both medical and mental health needs in the older population. We need smart solutions like Televëda that are able to develop a wrap-around system of care. Finally, it’s all about the health moonshot, and we see that mindset in Gurudanti and Mishra. “We think that we can create a positive impact here by empowering our civic organizations to create inclusive and accessible recreational centers around a social network,” Mishra says. Mishra and Gurudanti service clients with over 500,000 eligible seniors around the world. The team plans on rolling out their technology to health plans in the near future, allowing more seniors to find community, meaning, and purpose Televëda in the comfort of their own homes. 4 TELEVEDA@STARTUPHEALTH.COM

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HEALTH TRANSFORMERS Romy Antoine, CEO & Co-founder Jamie Smith, COO & Co-founder onestopwellness@startuphealth.com 32 StartUp Health Magazine / Issue 6

MEET THE HEALTH TRANSFORMERS

One Stop Wellness, the Workplace Wellness Program Employees Love Romy Antoine and his team have built a digital health literacy platform aimed to support employees in their journey to behavior change and help to reduce the risk of chronic disease.

MENTAL HEALTH & HAPPINESS MOONSHOT

One thing that the COVID-19 era taught us is that employee burnout is still a serious problem. A recent study stated that burnout has gotten more prevelant since 2020. Those who work virtually are more likely to say burnout has worsened throughout the pandemic (38%) than those working on-site (28%). Identifying the signs of burnout in the workplace can be tricky. They often creep up as early symptoms — stress or anxiety — before becoming more acute. Research has indicated that in some cases, burnout has led to even more severe outcomes like type 2 diabetes, coronary heart disease, gastrointestinal issues, and more. As a result, employers — some for the first time — have made a conscious effort to focus on navigating their staff ’s mental well-being. However, coronavirus research has suggested that these programs often don’t adequately address workplace mental health, and fall short of the necessary ac-

tions and follow-up needed to accurately and thoroughly address the problem. Furthermore, studies show that as more people are working from home, they struggle to stay engaged with these programs as most of them are standard PDFs and not personalized to an individual’s health concerns. While the future remains unknown, one thing is clear: Employee burnout is a reality that companies can’t afford to overlook. Thankfully, one startup is rethinking employee engagement and helping employees live happier, healthier, and more productive lives.

VINTAGE 2021 (FUND II) ONESTOPWELLNESS.COM

origin story

Romy Antoine has always had a passion for helping people. He studied biology and exercise science in college before launching a fitness company that provided health coaching and nutrition consulting for clients around the globe. His virtual practice consisted of short, 20-minute workshops startuphealth.com 33

MEET THE HEALTH TRANSFORMERS

where he provided personalized workouts and meal planning rooted in science to help individuals live a stress-free, healthier lifestyle. One day, Antoine was speaking with a woman who said she had gained over 20 pounds in the first six months at her job, was extremely stressed, depressed, and had no energy to do much of anything outside of work. He began working with the woman, training her, and helping her shed pounds of unwanted weight. After three months, she was happier than ever. Antoine was asked to do a presentation for her organization and the rest was history. He soon began giving presentations at multiple companies across the country, training teams on how to create a stressfree work environment. Antoine realized this was an untapped market in the healthcare industry and that every organization around the world needed this education for the wellbeing of their employees. At the time, Antoine’s mother was battling stage 4 bile duct cancer. One day, she came home and told Antoine that the doctors were providing her with a personal nurse who would come to the house and take care of her. What Antoine’s mother didn’t realize was that they were actually placing her in hospice; that fact was lost in translation. It occurred to Antoine that like his mother, a lot of people don’t understand what their doctors are telling them, and this is a big reason why employee wellness programs haven’t worked. As he dug deeper into the issue, he found that there weren’t any programs that were providing adequate mental wellness coaching that 34 StartUp Health Magazine / Issue 6

was easy to understand and based on an individual’s health. “That’s where I saw the biggest flaw in the medical industry,” Antoine says. “Patients are given all of these diagnoses with big names and they might understand what their doctor is saying at their appointment but once they get home, they forget everything. That was the moment when I realized that if we could make it really simple, easy to learn and remember, that would really change the industry and put a value on healthcare.” So, he teamed up with colleague Jamie Smith, digital marketing and data analytics expert who was also passionate about making people healthier, and discussed his vision for One Stop Wellness. under the hood

The main principle behind One Stop Wellness is simple: A workplace wellness program that helps employees build healthy habits one step at a time. The mobile platform delivers a personalized wellness program to support employees in their journey to behavior change. Antoine’s team uses data science to identify potential health risks and motivate employees to reduce risk factors. Through daily lifestyle and emotional health checkins, employees can earn meaningful rewards, track their goals and get the support they need for improvements. Here’s how it works. Once an organization has adopted One Stop Wellness, employees can log in from their desktop computer or cell phones and answer a series of questions based on their goals and lifestyle: How active are you?

What foods do you enjoy eating? When was the last time you visited your primary care physician? Through these health assessments and a mood tracker, One Stop Wellness can identify whether someone is dealing with stress, fatigue, or burnout, and offer their personalized wellness program. “We have realized in the workplace that most companies have these programs but they’re only being utilized by 2% of the population, and that’s only because employees don’t know they exist,” Antoine says. Employees have access to a library of virtual wellness classes designed with a masterclass-styled experience. All classes are under 12 minutes and led by experts in fitness, mindfulness, emotional health, nutrition, and cooking. Classes include human performance improvement, financial fitness, improvisation classes, professional development training, healthy eating, energy and time management, health coaching, on-site fitness classes, health fairs, wellness webinars, and more. Workers can also upload a biometric screening, which includes their bloodwork and measurements like height, weight, and waist circumference, and receive a snapshot of their risk of chronic health issues like diabetes, hypertension, high cholesterol, and more. Using that data, Antoine and his team built an AI-personalization engine that recommends videos, games, and trivia questions based upon a person’s risks, and a personalized wellness plan to improve those risks. Employers have access to their company’s entire dashboard to keep track of employee wellness, engagement levels,

progress, and more. why we're proud to invest

There are a lot of reasons to be excited about what Romy and Jamie have built. For one, they’re tapping into a massive area in health innovation that in the past, has long been neglected. The pandemic offered a wake-up call to organizations worldwide to break through the stigma around employee burnout and learn to provide adequate mental healthcare to their employees. Industry leaders can no longer avoid the mental health of their staff and must learn to accommodate people who are dealing with challenges that oftentimes are invisible and difficult to talk about. As many as 40 percent of workers reported they deal with one or more acute mental health conditions such as anxiety, depression, or posttraumatic stress disorder versus 20.6 percent at the start of 2020. And One Stop Wellness has developed a strategic approach to improve these numbers and empower employees to improve their lifestyles, productivity, and overall wellbeing — and it works. We’re also proud to support One Stop Wellness because they’re big on impact. “We have a social impact mission of empowering people to have access to their healthcare data and provide the education and healthcare literacy to help them become their own healthcare advocates,” Antoine says. “Through One Stop Wellness, the big picture is really not just giving them that data but helping them to make better decisions, utilize their healthcare better, save money, and live better lives.” 4 ONESTOPWELLNESS@STARTUPHEALTH.COM startuphealth.com 35

MEET THE HEALTH TRANSFORMERS

HEALTH TRANSFORMERS Anne Wanlund, CEO & Co-founder Ann Don Bosco, Director & Co-founder canopie@startuphealth.com

Canopie Offers Customized Mental Health Coaching for New Moms With their new app, public health veterans Anne Wanlund (above) and Ann Don Bosco (opposite) draw on evidence-based therapy techniques to tackle postpartum depression.

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WOMEN'S HEALTH MOONSHOT VINTAGE: 2021/Q2 CANOPIE.ORG

If you take five new mothers, statistically at least one of them will suffer from postpartum depression (PPD). That’s a huge number of women – likely someone you know – who are dealing with symptoms like insomnia, loss of appetite, intense irritability, and difficulty bonding with their baby. If left untreated, PPD can lead to chronic depression. Postpartum depression and anxiety isn’t new, but it's been exacerbated in the age of social media. On Instagram and Facebook sleep deprived new mothers are served up photos of picture perfect women thriving in their new maternity, juggling meals, naps and jobs with ease. This ever-present hyperreality leaves many moms feeling ashamed and isolated . . . and with lots of questions. Shouldn’t I be happier? Have I given up my identity? How did that woman just bake a sourdough loaf and I can’t even find a clean shirt to put on? And PPD isn’t just a health challenge; it’s also incredibly expensive. It’s estimated that postpartum depression causes $14.2B in economic loss each year, and depression and anxiety result in an additional 2.9B in health expenditures each year. In fact, 90% of maternal health expenditures come from depressed moms. In other words, PPD is expensive to treat, and even more expensive to ignore. Add it all up and you have a public health crisis. Postpartum depression is worsening health disparities because low income moms are less likely to get treatment, which can negatively affect their children for the rest of their lives. Anne Wanlund and Ann

Don Bosco knew we could do better for new moms, that while anxiety and depression are the number one complications of pregnancy and childbirth, there are effective ways to prevent and treat it. So this year they teamed up to build Canopie and address the problem head on. origin story

Anne Wanlund and Ann Don Bosco have worked in public health for their entire careers, albeit on different continents. For Wanlund, that journey took her to East Africa, where she led award-winning social enterprises for five years. Then two things happened that would shift and clarify her health moonshot mission. First, she got pregnant. Then, after she and her husband moved back to the United States from Tanzania to deliver the baby, she was hit with an unexpected wave of anxiety. “Every night I would stay up and I would Google the effect that anxiety has on a baby in utero. I couldn’t sleep. I did that for months. I now recognize that this was rustartuphealth.com 37

MEET THE HEALTH TRANSFORMERS

mination, which can be a precursor to postpartum depression.” When she told friends and family about her struggle, others came out of the woodwork to share their similar experiences. As she dug into the numbers she realized just how pervasive the problem was. It reminded her of experiences she’d had working with new mothers in Rwanda whose babies were malnourished. She realized many of those women were likely struggling with symptoms of postpartum depression, and that lack of connection with their baby made it difficult to nurse. In fact, addressing this seemingly narrow health issue could significantly affect some of the most dire health challenges in other countries, improving the lives of millions. To take these ideas to the next level, Anne joined Charity Entrepreneurship, a social impact incubator based in the United Kingdom. During the program, which focused on cost-effective, research-based global health solutions, she met Ann Don Bosco. “Ann was in a similar frame of mind and we really connected from day one,” says Wanlund. Don Bosco lived in the United Kingdom and had experience designing digital mental health campaigns for the NHS. That work led her to head up a social impact team at Google, and to consult for the likes of Microsoft, Disney and CocaCola. “There's such potential for digital products to meet the enormous gap in mental health needs,” says Don Bosco. “Everyone should be taught CBT, since we know it works and the concepts are fairly simple. Why is it that these techniques aren't available to everyone? That feels like a huge 38 StartUp Health Magazine / Issue 6

missed opportunity.” With their shared passion for global health and Wanlund’s personal experience as a new mom, the two narrowed their focus to PPD and the idea of Canopie was born. The two were passionate about rooting their ideas in research, so their first step was to conduct their own study of 100 mothers, across multiple countries and socio-economic backgrounds. The results were even more dramatic than they anticipated: 70% of mothers reported feeling like their mental health suffered more during the first year of their child's life than at any other point. under the hood

Canopie users typically arrive at the app by way of a referral from a pediatrician or obstetrician. Once the user downloads the app she fills out a HIPAA-secure survey so that the Canopie team quickly understands where she falls on a clinically-validated depression scale. That scoring process allows Canopie to stratify users and guide anyone experiencing extreme depression, or postpartum psychosis, to emergency in-person care. Next, Canopie creates a customized, guided program to address the challenges each mom is facing. These programs weave together tools and concepts from three schools of therapy. The first is Cognitive Behavioral Therapy (CBT), an umbrella concept that refers to helping people identify and change the thoughts negatively impacting their mood and wellbeing. The second is Compassion Focused Therapy (CFT), which focuses on reducing selfcriticism and shame. Finally, Canopie in-

corporates Interpersonal Therapy (IPT), which centers on the role of relationships and communication in reducing depression and stress. The nuanced combination of these three therapy styles is part of what makes this platform unique and effective. “We’re normalizing her common experiences, like worrying about her baby’s safety, but also delivering a program of focused therapy to reduce feelings of shame and stigma,” says Wanlund. The program is served up in a format designed for busy moms. It’s available 24/7 (sometimes you need help at 2am), delivered in audio form (allowing moms to keep their hands free), and each session is under five minute (because what new mom has half an hour to burn?). why we're proud to invest

The best health innovations – or at least those that have the integrity to withstand the long healthcare sales cycles – are born out of a personal passion. For Anne Wanlund, that means caring for new moms struggling with their mental health just like she did. But personal passion is just the spark. Anne Wanlund and Ann Don Bosco also have the on-the-ground experience to bring that passion to life. The two combine years of executive experience in global health, digital health rollouts and research. They have a deep understanding of the policies that underpin public health, and how change happens one patient at a time. Another reason we’re excited to partner with Canopie is their early emphasis on evidence. Their app was born out of the cofounders’ own research, and they continue

We’re normalizing her common experiences, like worrying about her baby’s safety, but also delivering a program of focused therapy to reduce feelings of shame and stigma.

to gather the evidence needed to prove definitively that this kind of mental health care for new moms can serve the double bottom line – improving health metrics while decreasing costs. In their early randomized controlled trial results, 83% of participants who started with moderate to severe depression and 50% of participants who started with moderate to severe anxiety decreased to below referral threshold. 96% of participants reported a positive change in emotional health. This emphasis on hard data and proven results is what Canopie will need to be integrated into the workflow of large health systems. Anne Wanlund and Ann Don Bosco have the experience, drive and proven results needed to tackle a massive unmet need in women’s health, and we’re excited to be on that health moonshot journey with them. 4 CANOPIE@STARTUPHEALTH.COM

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HEALTH TRANSFORMERS Ben Pasco-Anderson, CEO & Co-founder Ari Blonder, COO & Co-founder prosprhealth@startuphealth.com 40 StartUp Health Magazine / Issue 6

MEET THE HEALTH TRANSFORMERS

Prospr Health Is Using Cash Incentives to Encourage Healthy Habits and Save Lives Ben Pasco-Anderson and Ari Blonder have created a new way to enable employers and insurers to directly invest in the health of their people, and the early results are promising.

CURE DISEASE MOONSHOT VINTAGE: 2021/Q2 PROSPRHEALTH.COM

In the realm of illness and disease, there is an awful lot that we cannot control. Healthy, young people can get brain tumors and middle-aged marathoners can get diagnosed with ALS. So many illnesses and diseases feel disassociated from our life or behavior. But there’s another category in health, one where we do have control, and our behaviors have an immediate impact on our health outcomes. The prime example of this is in a person’s weight, or BMI. When we live in such a way – through diet and physical activity – as to keep ourselves within a healthy weight range, we dramatically decrease the risk of two of the most common causes of death in the world, heart disease and diabetes. While so many

illnesses and diseases feel random, this is pretty predictable and rational: for almost anyone who is medically overweight, dropping pounds adds years to your life. It seems so simple, so controllable, yet we see an obesity epidemic burning unchecked in most of the world. One in 3 Americans is obese, and according to the World Health Organization (WHO), 2.8 million people die each year as a result of being obese or overweight. From Weight Watchers to psychotherapy, there’s been no shortage of diet schemes and behavior change programs. It’s gotten national attention too, like the Let’s Move! campaign spearheaded by former first lady Michelle Obama. And yet, nothing seems to help people make better daily choices about their diet and exercise. Compoundstartuphealth.com 41

MEET THE HEALTH TRANSFORMERS

ing the problem is that unhealthy lifestyle decisions don’t just impact the individual. They also drive up healthcare costs for society. Prospr Health is a new startup taking aim not only at the obesity epidemic, but at the underlying issues of discipline and accountability that lead to smarter, more sustainable lifestyle choices. origin story

Ben Pasco-Anderson and Ari Blonder were friends long before they were business partners. They met in the hallway of their sophomore dorm at the University of Massachusetts and then bonded over a shared computer science course. “Both of our mothers are named Mindy, so we had a lot to bond over,” laughs Blonder. After college the two got a place together and Ari began working as a medical assistant in a cardiac ICU at Mass General. Here, he worked with patients recovering from invasive and expensive procedures, many of them preventable if not for the common thread that tied many of these ICU patients together – their unhealthy weight. “Ari would routinely come home from a shift and tell me about how so many of the procedures and the pain and the expense associated with these conditions were avoidable by taking care of your health up front and listening to warning signs,” remembers Pasco-Anderson. That frustration sent the two down a rabbit hole of research. There are a thousand programs for losing weight, which could save lives and billions of dollars. Why 42 StartUp Health Magazine / Issue 6

weren’t they working? “Nothing out there is really moving the needle and pushing people towards living healthier lives,” says Pasco-Anderson. So they set out to take the best in behavior change technology and wrap it into an engagement platform that uses smart incentives to teach healthy behaviors. “We’re not trying to solve the obesity epidemic,” says Ben. “That’s a symptom of the challenge. “The real challenge is education, discipline and accountability.” under the hood

When people sign up for Prospr’s app, they’re first guided to select their payer. That could be their insurance company or their employer. Ben and Ari set it up that way because they’re all about aligning incentives. Whoever is liable for the person’s health costs has a strong incentive to help this person get into a healthy weight range. The user then sets a health goal. Currently, Prospr is focused on weight loss goals, but will expand in the future to more nuanced goals like reducing A1C levels (for diabetics), improving cholesterol levels or other objective-based goals. These goals are then aligned with a coaching curriculum. Importantly, says Ben, this curriculum isn’t proscriptive, like “go bench press 100 lbs” or “walk five miles.” Instead, it offers a framework for making better decisions. These can be small tweaks, like walking while you’re on the phone or stretching while you watch tv. “These little habit changes, when you start stacking them on top of each other, add up, and people start to feel better,” says Pasco-Anderson. “They start to experience

wins, which encourages further habit formation.” But here’s where Prospr gets more interesting. Ben and Ari have created a system that makes it fast and simple to compensate users for achieving their health goals. “When a user verifies progress (self weigh in, or visits their doctor), we confirm accuracy and then trigger an immediate cash payout.” After conducting user research, the company settled on a payout of $20 per pound lost, which is automatically deposited into the user’s bank account within seconds of verifying their progress. Once they get into a healthy weight range, users are then rewarded financially over time for keeping the weight off. So far, the results are impressive. Prospr has been able to prove a 600% return on investment. In other words, rewarding people for building healthy habits appears to help them while also improving their insurer’s bottom line. why we're proud to invest

One of the things we love about Prospr is that the team is tackling one of the most intractable health problems in the world, but with a creative spin. If we’re going to improve global health, we have to address obesity, and we’re not going to make a dent relying on old methods that never worked. We need to see old problems with a new lens, and that’s just what Ben and Ari are doing. Another reason we’re bullish on Prospr is that they’re doing the hard, essential work of aligning healthcare incentives. For years, the healthcare industry has

Prospr Health realigns incentives by making it easy for employers and insurance companies to directly invest in the health of their people.

been plagued by what many people call “perverse incentives.” Hospitals are incentivized to do unnecessary tests, insurance companies are incentivized to pay for as little care as possible, and patients are left suspicious and broke. Insurers, providers and patients are too often in an antagonistic relationship, rather than working in sync towards a common goal. Prospr disrupts this relationship – and realigns incentives – by making it easy for employers and insurance companies to directly invest in the health of their people. This would be exciting if only for the positive ROI for insurance providers and employers. After all, lower premiums mean greater access to care. But the real beauty of the Prospr method is that it’s actually working to change habits and improve lives. So far their innovative combo of coaching and cash incentives has achieved a 70% goal performance rate. Streamlined cash incentives for weight loss is just the beginning. This wellness platform is laying the foundations for a new way to think about behavior change, accountability and discipline and we’re proud to be along for the ride.. 4 PROSPRHEALTH@STARTUPHEALTH.COM startuphealth.com 43

Health Transformer News at a glance When you have a global army of 250 active health innovation companies, there's exciting health moonshot progress every single day. We couldn't print it all, so here are just a few headline highlights from the last quarter.

For daily health moonshot news updates, follow StartUp Health on Twitter @startuphealth and read the StartUp Health Insider newsletter startuphealth.com/insider 44 StartUp Health Magazine / Issue 6

Billing Software Startup Inbox Health Raises $15M

Yumlish CEO & Founder Shireen Abdullah

MEDCITY NEWS 4/5/21

The American Diabetes Association and Yumlish Make Virtual National DPP Program Available to 88 Million Americans With Prediabetes AMERICAN DIABETES ASSOCIATION 4/8/21

Gilbert-Based PayGround Raises $4M; Looks to Simplify the World of Medical Bill Payments PHOENIX BUSINESS JOURNAL 4/13/21

Using New Approaches to AI and Cell Biology, Cyclica May Have Uncovered a Novel Drug Target for COVID-19: Humans Themselves FIERCEBIOTECH 4/14/21

1Doc3, a Colombian Telemedicine Startup, Raises $3 Million TECHCRUNCH 4/16/21

5 Health-Tech Startups to Watch in 2021: Babyscripts ENTREPRENEUR 4/21/21

Quantgene Teams With Cancer Therapy Guidance Company LOS ANGELES BUSINESS JOURNAL 4/26/21

Keto-Based Digital Diabetes Program Virta Health Nets Another $133M MEDCITY NEWS 4/26/21 startuphealth.com 45

HEALTH TRANSFORMER NEWS // AT A GLANCE

Ethical Entrepreneurship: Kevin Dedner of Hurdle Is Making the Right Call NASDAQ 4/28/21

Creating a Resilient Business, Alerje Founder Weighs In NATIONWIDE 5/1/21

Particle Health Expands Beta Program API to Consumer Digital Health Providers – Enabling Instant Access to Patient Records HIT CONSULTANT 5/3/21

Sift Healthcare Raises $2.5 Million, Grows Amid Rising Interest in Healthcare Payment Analytics MILWAUKEE BUSINESS NEWS 5/5/21

46 StartUp Health Magazine / Issue 6

YourCoach Looks to Employer Space With New Version of Wellness Platform MOBIHEALTHNEWS 5/11/21

How Cityblock Health Is Tapping Into Technology to Better Care for Medicaid Patients STAT NEWS 5/12/21

Beam Health CEO on How the Startup Needed to Evolve Beyond Telehealth to Deliver Value MEDCITY NEWS 5/14/21

DarioHealth Expands Mental Health Foothold With wayForward Acquisition MOBIHEALTHNEWS 5/18/21

Javier Evelyn, CEO & Founder of Alerje

How the Co-Founders of Cityblock Plan to Transform Healthcare INC. FOUNDERS PROJECT PODCAST 5/19/21

Quantgene Offers Consumers Liquid Biopsy Early Cancer Detection Service GENOME WEB 5/20/21

Banner Health Launches Digital Health Program With Xealth and Babyscripts BECKER'S HEALTH IT 5/20/21

The 2021 CNBC Disruptor 50 Companies: Cityblock Health CNBC 5/25/21

startuphealth.com 47

HEALTH TRANSFORMER NEWS // AT A GLANCE Navya Singh, co-founder of wayForward, which was acquired by DarioHealth in May, 2021.

Portland Startup Gabbi Is Fighting Delayed Diagnosis in Women's Health

Menopause Is Having a Moment in Part Thanks to Companies Like Gennev

PORTLAND BUSINESS JOURNAL 6/1/21

VOX 6/3/21

‘Care Bots’ – Like CarePredict – Are on the Rise

Wisdom From Cyclica: Opportunities and Challenges for AI in Drug Discovery

THE GUARDIAN 6/3/21

48 StartUp Health Magazine / Issue 6

DRUG DISCOVERY WORLD 6/7/21

Jill Angelo, CEO and founder at Gennev

HoyHealth CEO on Providing Equal Care for All Patients

Medical Transportation Startup Ride Health Snags $10M in Funding

YAHOO! FINANCE 6/10/21

MOBIHEALTHNEWS 6/21/21

Meet the Honorees for Our 2021 40 Under 40 Awards: Kavi Misri of Rose Health WASHINGTON BUSINESS JOURNAL 6/11/21

How Technology Like Hucu.ai Addresses Care Coordination Challenges MCKNIGHT'S SENIOR LIVING 6/17/21

52 Women-Led Startups Driving the Future of HealthTech and FemTech FORBES 6/24/21

Cleveland Surgical Technology Developer Indago Raises $10M, Changes Name to Lazurite CLEVELAND BUSINESS JOURNAL 6/25/21

startuphealth.com 49

STARTUP HEALTH NEWS

Nasdaq Helsinki HEALTH.HE

Blood Testing Startup Nightingale IPOs on Finnish Nasdaq For CEO and founder Teemu Suna (pictured), this milestone is just a warm-up for what comes next.

50 StartUp Health Magazine / Issue 6

StartUp Health first backed Suna and his team in 2016

Here is a picture of what

blood testing looks like today: A patient with high cholesterol pays a visit to their doctor and is prescribed a lipid panel of lab tests to check their cholesterol, triglycerides, and glucose levels. Many times, these blood tests are being sold by the diagnostics providers and are priced per test, creating a financial knee-jerk that pans out in one of two ways: a doctor orders the bare minimum tests to save the patient dollars, or they order numerous tests and the patient receives a pricey medical bill. “The current model inhibits a doctor’s ability or willingness to prescribe additional tests that will give them a fuller picture of the patient’s health,” says Teemu Suna, CEO and Co-founder of Nightingale, which joined StartUp Health in 2016. Nightingale, which IPO’d on the Finnish Nasdaq last week, is working to change the entire blood testing paradigm, opening up access to highly-sensitive tests while dropping prices dramatically. Here’s how it works. Once someone‘s blood sample is received, Nightingale’s technology analyzes blood samples using nuclear magnetic resonance (NMR) spectroscopy. Think of NMR as a cousin to the MRI, which uses similar principles of magnetic resonance to create pictures of the inside of the body. The blood analysis is converted and combined into a spectrum that Nightingale’s advanced statistical software transposes into readable measurements. The measurement of biological molecules, or biomarkers, present in blood (e.g. glucose, lipids and amino acids) provides a bird’s eye view of

a person’s health. Nightingale’s biomarker analysis technology uses a technique that measures over 220 biomarkers from a single blood sample, which is about 40 times more than what the average clinician assesses. The result of this wizardry under the hood? Nightingale’s biomarkers can detect a disease 10 years before its onset. The recent IPO will allow Suna and his team to double down on this work and scale it globally. “This is the largest First North IPO in Finland and one of the largest primary-only IPOs ever on Nasdaq Helsinki stock exchange,” says Suna. “We are very proud of Nightingale’s accomplishments so far, but for us, this is just the beginning. Over the past five years, we have transparently validated our unique blood testing technology with regulatory approvals and more than 300 peer-reviewed scientific publications. We are now in an excellent position to continue our mission to help everyone live a healthier life.” “We are very proud to be one of the pioneering publicly listed growth companies in Finland,” says Timo Soininen, Chairman of Nightingale’s Board of Directors. “As our objective is to deliver long-term growth and value for our shareholders, none of the current shareholders sold any of their shares in the IPO and all the funds will be used to accelerate Nightingale’s growth. We wish to thank our existing shareholders for their long-term support and warmly welcome new shareholders to join Nightingale in building the next era of our growth.” 4 NIGHTINGALE@STARTUPHEALTH.COM

startuphealth.com 51

STARTUP HEALTH NEWS

StartUp Health’s New Rolling Impact Fund Makes It Easy to Invest in Health Moonshots 52 StartUp Health Magazine / Issue 6

In 2013, Doctor.com

The new member-driven ‘StartUp Health Moonshots Impact Fund’ enables accredited clinicians, patients, families, and organizations to automatically invest in a global portfolio of private companies dedicated to achieving health moonshots via a flexible quarterly subscription.

was just three people with a great domain name and a dream, renting desks in a loft in New York City. “Even calling us a baby company back then would be generous,” says the company’s co-founder Andrei Zimiles with a laugh. At that early stage, one of Zimiles’ greatest challenges was access. Being an emerging player in a massive health market made it nearly impossible to land conversations with big decision-makers. That tide began to shift in 2013 when they joined StartUp Health and became part of the company’s community of “Health Transformers.” “I can’t tell you how many times we pushed out news through the StartUp Health community and it echoed out across the whole ecosystem,” says Zimiles. “We’d get inbounds from Fortune 500 companies, investors, and health systems saying they saw our news in the StartUp Health newsletter. StartUp Health also brought us out of our comfort zone and challenged us to think way bigger.” Over seven years Doctor.com grew from three humble desks to more than 170 employees and last fall had an acquisition by Press Ganey. Their story is emblematic of how StartUp Health has worked with hundreds of early-stage health startups over the past decade. “Ten years ago this week we launched StartUp Health on a 25-year mission to invest in and support a global army of entrepreneurs and innovators committed to achieving Health Moonshots,” says StartUp Health CEO, Co-founder, and

startuphealth.com 53

STARTUP HEALTH NEWS

Managing Partner Steven Krein. “Over the past decade, we’ve built a scalable collaborative innovation platform and community, launched three funds, and made more than 360 early-stage health moonshot investments.” StartUp Health has backed health innovation companies from 26 countries and has averaged 46 new investments per year since 2013. Until recently, investment in StartUp Health’s diverse, global fund of early-stage healthcare startups was available only to an extremely limited list of institutional backers and super angel investors via traditional venture funds that required significant investment minimums and multiyear commitments. But in April 2021, as part of a new rolling fund platform created by AngelList, StartUp Health launched the StartUp Health Moonshot Impact Fund to expand the universe of health moonshot investors and simplify the process of backing portfolios of early-stage health startups. Now StartUp Health Moonshot Impact Fund — and its unique process for nurturing Health Transformers and achieving health moonshots — is open to any qualified accredited clinician, patient, family, or organization via a flexible quarterly subscription with significantly lower minimums. This platform enables investors to “subscribe” to the StartUp Health Moonshots Impact Fund and automatically invest a regular sum each quarter. The investment process is simple, automated, flexible, and comes with a host of membership benefits like access to follow-on investment opportunities, testing and trialing health solutions early to provide feedback, and par54 StartUp Health Magazine / Issue 6

ticipation in fireside chats and showcases to meet the founders working to achieve the health moonshots. Each quarterly fund will make approximately seven to 15 investments in private early-stage health tech startups. “At the heart of our investments is a double bottom line thesis,” says Krein. “We believe that by investing in a generation of health moonshot companies early — and supporting them with StartUp Health’s platform of resources, coaching, and networks — we can speed up the process of achieving health moonshots. This is why we think it’s so important to simplify the process for investing in portfolios of Health Transformers every quarter, and radically expand the networks of backers to the community of health startups.” Mindset Matters Most: How StartUp Health Picks Health Transformers StartUp Health has invested in more than 360 companies, and that experience has helped it create a unique and scalable way to assess entrepreneurs and companies. It starts by scoring entrepreneurs and founder teams using StartUp Health’s proprietary “Health Transformer Scorecards” which have been refined over the past decade of investing in and working with healthcare founders. In this process StartUp Health is assessing for attributes like long-term commitment, collaborative relationships, confident ambition, and self-awareness. They then move on to scoring the company on things like moonshot vision, team, partners, and differentiated brand. This scoring methodology, developed over years of reviewing thousands of startups, allows the company to perform a uniform investment process

based on data. Currently, StartUp Health has 245 active portfolio companies, ranging from pre-seed to post-IPO. StartUp Health portfolio companies have raised more than $2.8B in funds from more than 450 co-investors, including many of the most notable VCs in the industry. To date, there have been 27 exits from the portfolio. “Some of these 27 acquisitions have been lucrative and some have not, but through it all, we’ve gained experience and perspective on the market,” says Unity Stoakes, President, Co-founder, and Managing Partner at StartUp Health. “One of the things we’ve learned that creates opportunity is investing in traditionally under-represented entrepreneurs. We’re proud to say that the StartUp Health portfolio is made up of 32% female founders, 33% BIPOC founders, 25% physician and PhD founders, and 16% serial entrepreneurs.” Getting Started As An Impact Fund Member Becoming a “member” of the Impact Fund is about more than a quarterly investment. Members of the fund are welcomed into StartUp Health’s community of like-minded entrepreneurs, investors, industry experts, and consumers, committed to achieving 12 Health Moonshots — audacious health goals like improving access to care, ending cancer, curing diabetes, and radically improving children’s health. Impact Fund members get first-look access to allocation opportunities in portfolio companies as well as weekly deal alerts about new funding

rounds. Members receive portfolio updates and health innovation insights via StartUp Health’s award-winning media platform. And, Impact Fund members gain access to invite-only events where we celebrate the health innovation progress being made. In creating the StartUp Health Moonshots Impact Fund, one major goal is simplicity. All relevant information can be found at healthmoonshots.com and accredited investors can sign up to attend an Impact Fund informational webinar. Tiered investment minimums apply for health professionals, individuals, and organizations. Members in the fund can increase their investment at any time, and after four quarters in the fund, they can pause or reduce their investment. “We believe that one of the critical ingredients to achieving health moonshots is to invite to the table investors and partners who have a similar mindset,” says Krein. “We need families, doctors, and organizations who care as much about these health moonshots as we do. We believe that as we emerge from the COVID-19 pandemic, we’re truly in a unique moment in time for health innovation. The world has changed, and so has the opportunity for investing in health innovation.” StartUp Health has an Impact Board currently composed of 12 health leaders including people like Dr. Toby Crosgrove, the former CEO of the Cleveland Clinic; Sue Siegel, former CEO of GE Ventures; Margaret Laws, CEO of Hope Labs; and Way to Wellville CEO, Esther Dyson. For more info visit www.healthmoonshots.com. startuphealth.com 55

StartUp Health Insights | 2021 MIDYEAR REPORT

With $20B Raised Globally in the First Half of 2021, Health Innovation Funding Doubles in One Year

For the latest in health innovation funding go to startuphealth.com/insights-reports 56 StartUp Health Magazine / Issue 6

For the last decade, we at StartUp Health have beat the drum that together we can achieve health moonshots, but it’s going to take a kind of investment that we’ve never dreamed possible. This report’s record funding numbers, which far eclipse last year’s banner numbers, are finally beginning to crack the surface of what we believe is possible.

58 Total Funding Year Over Year

67 M&A Activity

63 Top Health Innovation Deals

68 IPOs & SPACs

65 Top Health Innovation Hubs

69 Most Active Investors startuphealth.com 57

StartUp Health Insights | 2021 MIDYEAR REPORT

Funding announcements

essential opportunity to step back, take a beat, and view the market with a longer lens. What’s the 10,000-foot view? We also take this opportunity to look at funding trends from a health moonshot perspective. Are we investing in the tools and services that will increase access to

in health innovation have been coming in hot and fast these days. It’s easy to lose perspective about where we’ve come from and where we’re going. This 2021 midyear StartUp Health Insights Report (something we’ve been doing for a decade) is an

Global Health Innovation Funding Midyear YOY Total Raised (Midyear)

Total Deals (Midyear)

309

28 268

262

179

$4. $3.4B

128

$930M MIDYEAR 2011

$1.4

$1.1B MIDYEAR 2012

$3.0B

MIDYEAR 2013

MIDYEAR 2014

MIDYEAR 2015

MIDYEA

Source: StartUp Health Insights | startuphealth.com/insights. Note: Report based on publicly available data through 6/30/21 on seed (incl. accelerator), venture, corporate vent

58 StartUp Health Magazine / Issue 6

care, cure disease, lower cost, and achieve the other global goals that can improve the lives of billions of people? Let’s look at the numbers. The Covid comeback from a year ago has continued and accelerated One year ago, in the 2020 StartUp

Health Insights Midyear Report, we closed out the most-funded six-month period on record. That report came at the height of the first wave of the COVID-19 pandemic, back when all bets were off. Lockdowns caused markets to freeze, and it was anyone’s guess how $20.1B 482

457

389 358

353

$9.7B

$6.7B

$7.3B

$7.8B

.2B

AR 2016

MIDYEAR 2017

MIDYEAR 2018

MIDYEAR 2019

MIDYEAR 2020

MIDYEAR 2021

ture, and private equity funding only. Companies tracked in StartUp Health Insights may fall under multiple moonshots and therefore will be represented throughout the report.

startuphealth.com 59

StartUp Health Insights | 2021 MIDYEAR REPORT quickly they’d thaw. Now, looking back, it seems almost obvious that health innovation bounced back quickly. After all, in a contactless, virus-filled world, what do we need more than telemedicine, remote monitoring, and app-based mental health? But at the time, it was anything but certain. Early

in the pandemic, in analyzing the first quarter’s banner funding, MedCity News wrote that “faced with a global pandemic, the trend is unlikely to continue.” As famed investment analyst, Yogi Berra put it, “It’s tough to make predictions, especially about the future.” After a moment of panic (for pretty

Global Health Innovation Funding Year Over Year Midyear Total

Annual Total

$8.2 $7.1B $6.1B

$4.2

$2.1B

$2.3B

$930M

$1.1B

2011

2012

$2.8B

$3.4B

$3.0B

$1.4B 2013

2014

2015

201

Source: StartUp Health Insights | startuphealth.com/insights. Note: Report based on publicly available data through 6/30/21 on seed (incl. accelerator), venture, corporate ventur

60 StartUp Health Magazine / Issue 6

much every market on every continent) health innovation began an upward climb in both adoption and investor interest. That up-and-to-the-left trajectory kicked off one year ago, continues today, and has accelerated significantly. Total funds raised skyrocket, fueled by ceiling-breaking mega deals

The biggest headline from this midyear report is the total funding number. In the first six months of 2021, we tracked a little over $20B in funds raised. To put that in perspective, that’s nearly as much as was raised in all of 2020, which was itself a banner year. While money has flooded the health in-

$21.9B $20.1B

$15.2B $14B

$11.8B

$9.7B

2B $6.7B

$7.3B

$7.8B

2017

2018

2019

2020

2021

ure, and private equity funding only. Companies tracked in StartUp Health Insights may fall under multiple moonshots and therefore will be represented throughout the report.

startuphealth.com 61

StartUp Health Insights | 2021 MIDYEAR REPORT novation market in 2021, the number of deals has risen more gradually. That’s because we’re seeing more and more blockbuster mega deals. The biggest investment deal in Q2 was a mammoth $600M raise for CMR Surgical. We’ll get into why this specific raise is meaningful below, but for now, suffice it to say that deals this large (this one deal is half of what was raised in all of 2010) have the effect of changing the landscape. They alter the atmosphere, break ceilings, and redefine what is possible. How big and impactful can a health innovation company become? How much are we willing to invest to achieve health moonshots? We’re finally seeing the kinds of funding numbers that will begin to test this question. top deals

In the name of following-the-money, we look to our Top Deals list, both in and outside the United States, to learn how market priorities are shifting. The first thing that stands out is the diversity within the list. In past reports, we saw the Top Deals list dominated by just a couple areas of health, like home fitness and patient engagement. Before Covid shook up the market, the sense was that only certain kinds of health innovation companies were scalable and profitable enough for massive investment. Now, that’s changed. In this report, we see record-breaking mega deals in weight loss, telemedicine, drug discovery, mental health, pharmacy tech, research, insurance tech, and more. We’re seeing money flowing into consumer and B2B, to labs, and to laymen. That’s the reality both inside and outside the United States. Perhaps we’re enter62 StartUp Health Magazine / Issue 6

ing a period of creative growth (and risktaking) where potential is measured less by past market performance and more by health moonshot vision and true global needs. For the first time ever in the 10-year history of this report, the largest deal for the period came from outside the United States. CMR Surgical, based in Cambridge, England, raised $600M to expand access to its robotic surgery system, called Versius. This is notable not just for the gobsmacking size of the raise but because it’s an investment in bleeding-edge medical hardware. Typically deals of this size have been reserved for high-profit consumer products (like Peloton) and insurance platforms that cover millions of lives (like Bright Health). The fact that the last quarter’s biggest fundraise breaks open an exciting new field in high-tech remote medicine speaks volumes about the health moonshot mindset — and appetite for risk — in health innovation investing. Whether this big UK raise is the beginning of a pattern, a shift in investment focus, or an energizing of investment in Europe, has yet to be seen. Topping the largest deals list in the US was the $540M raised by Noom, the behavior change app helping people “lose weight and keep it off.” This comes as little surprise because for the last few years we’ve witnessed a race to see what company can bring evidence-based behavior change to consumers in a scalable way. This is low-tech territory (“eat this, not that”), but the potential impact couldn’t be higher. Whoever can crack the code on things like weight loss, sleep, and exercise can save or improve millions of lives while

Top Health Innovation Deals (Outside the US) Company

Country

CMR Surgical

England

$600M

Keep

China

$360M

PharmEasy

India

$323M

KRY

Sweden

$312M

Oxford Nanopore

England

$371M

AlayaCare

Canada

$225M

Alan

France

$220M

LetsGetChecked

Ireland

$150M

Huma (fka Medopad)

England

$130M

CeQur

Switzerland

$115M

reducing healthcare costs by untold billions. While Noom tops our list today, it’s just one of many entrants taking a crack at the daily behaviors that contribute to obesity, type 2 diabetes, and heart disease. Where the sector will shake out, or how it will consolidate, is still anyone’s guess. Other notable mega deals for the sec-

Amount Raised

ond quarter of 2021 include Lyra Health’s $387M, raised to expand their mental health programming for employees. This raise serves as a nod to the toll that COVID-19 has had on employee wellness and mental health writ large. No longer is it sufficient to rely on a mental health hotline buried in that employee handbook startuphealth.com 63

StartUp Health Insights | 2021 MIDYEAR REPORT

Top Health Innovation Deals (US) Company

City

Noom

New York, NY

$540M

Ro (fka Roman)

New York, NY

$500M

Insitro

San Francisco, CA

$400M

Lyra Health

Burlingame, CA

$387M

Hinge Health

San Francisco, CA

$300M

Capsule

New York, NY

$300M

AllyAlign Health

Richmond, VA

$300M

Valo Health

Boston, MA

$300M

Collective Health

San Francisco, CA

$280M

Komodo Health

San Francisco, CA

$264M

that gets 2% utilization. Companies like Lyra (and StartUp Health portfolio companies Rose Health, Hurdle, and wayForward) are presenting novel, tech-enabled solutions to meet employees where they’re at in their burnout, anxiety, and stress. “Employers are now listening to their employees and adding robust mental health care offerings to meet growing expectations,” says Kavi Misri, CEO and Founder of Rose Health, which joined the 64 StartUp Health Magazine / Issue 6

Amount Raised

StartUp Health portfolio in 2020. Swedish startup Kry raised $312M to expand its telemedicine offering in Europe. The company saw a 100% increase in adoption last year, even though healthcare usage was down overall. Post-pandemic, when people play catch-up with their health and come back to providers en masse, Kry will be ready with a new way of doing business. Two deals topping our lists focused on

upgrading how people get their prescription drugs. In India, PharmEasy raised $323M to expand the availability of their pharmacy app, while in the US, Capsule raised $300M to do similar work. Two deals that topped $200M focused on rethinking how insurance is handled. Collective Health raised $280M for their platform that combines online benefits management with virtual care services that keep employees healthy. Alan, a startup based in France, raised $220M to expand its insurance tech platform that is designed for the European markets. This single-payer environment hasn’t encouraged a lot of insurance innovation in the past, so we’ll be watching to see how Alan marries the worlds of governmentrun healthcare and independent, techenabled apps. What will the European version of insurance tech look like, and could it serve as a leapfrog moment for American insurers? hubs of innovation

While the list of most-funded US cities has its usual suspects at the top (San Francisco, New York City, and Boston), there are a few notable newcomers. Richmond, Baltimore, and Austin each made the list for the first time in a long time, with Austin racking up 13 deals. That makes Austin the fifth most active city in the US in terms of health innovation deals. Put together, the Mid-Atlantic trifecta of Philadelphia, Baltimore, and Washington, DC accounted for $714M in funding and 18 deals, which is a sharp uptick for the I-95 corridor. Continuing strong is Los Angeles which posted 15 deals and $423M

Hubs of Health Innovation (US) City/ Region

Funds Raised

Total Deals

San Francisco

$5.3B

NYC

$4.5B

Boston

$1.8B

Denver

$452M

Los Angeles

$423M

San Diego

$391M

Richmond

$302M

Baltimore

$289M

Austin

$238M

Washington, DC

$229M

raised for the quarter. The most notable feature on our list of most-funded cities outside the US is the low deal count. Compared with San Francisco’s 97 deals and New York City’s 91 deals, the most active city outside startuphealth.com 65

StartUp Health Insights | 2021 MIDYEAR REPORT

Hubs of Health Innovation (Non-US)

the US, London, saw a total of 17 deals. Three cities that made this list only posted a single deal, and most relied heavily on a single mega-deal to make the list. That said, Tel Aviv continues to be an active hub, with 11 deals and $223M raised, as does Toronto with five deals and $290M raised. exit activity

City/ Region

Funds Raised

Total Deals

London Metro Area

$642M

Cambridge

$603M

Stockholm

$385M

Beijing

$360M

Mumbai

$323M

Toronto

$290M

Paris

$252M

Tel Aviv Metro Area

$223M

Dublin

$201M

Horw, Switzerland

$115M

66 StartUp Health Magazine / Issue 6

Not shockingly, the surge in investor activity in health innovation has led to an increase in mergers and acquisitions as well. It’s a virtuous cycle where customer adoption fuels larger raises which lead to higher valuations and more valuable acquisition deals. The second quarter of 2021 saw three separate billion-dollar M&A deals in the sector compared with just one billion-dollar M&A deal in Q1 2021. Topping the list was a $13B acquisition of Change Healthcare by United Health Group, followed by Ciox Health’s $7B acquisition of Datavant. In general, the buyers in this active market are forward-thinking health tech companies consolidating the market or eliminating competitors as opposed to incumbents buying their way into the innovation market. We saw that with One Medical’s acquisition of Iora Health, Cedar’s acquisition of OODA Health, and Ro’s acquisition of Modern Fertility. We’ve written for years about the healthcare platform race, and we’re seeing that consolidation happen at an accelerating pace. The heat of the health innovation sector has led many companies to make the move to the public markets. In 2020 we counted

Health Innovation Acquisitions Company

Closing Date

Acquisition Amount

Acquirer

Change Healthcare

1/6/2021

$12.8B

UnitedHealth Group

Datavant

6/9/2021

$7B

Ciox Health

Iora Health

6/7/2021

$2.1B

One Medical

Therapy Brands

5/19/2021

$1.2B

KKR

OODA Health

5/13/2021

$425M

Cedar

Bardy Diagnostics

1/19/2021

$375M

HillRom

Modern Fertility

5/19/2021

$225M

Ro (fka Roman)

Intervention Insights (dba Trapelo Health)

3/24/2021

$65M

NeoGenomics Laboratories

Upright Technologies

1/27/2021

$31M

DarioHealth

wayForward

6/8/2021

$30M

DarioHealth

Eclat Health

3/23/2021

$30M

Gulf Capital

Hansei Solutions

3/23/2021

$30M

Gulf Capital

seven digital health initial public offerings (IPOs) and one SPAC. That caught our attention as prior to 2020 we might only track one or two IPOs in a year. In the first six months of 2021, we’ve already seen nine IPOs and 12 SPACs. Notably for

the StartUp Health family, Cloudbreak Health (which StartUp Health backed in 2017) completed a business combination with UpHealth Holdings, Inc, as part of a SPAC transaction led by GigCapital. “This combination gives us the opstartuphealth.com 67

StartUp Health Insights | 2021 MIDYEAR REPORT

IPOs

SPACs

Company

IPO Date

Company

IPO Date

Signify Health

2/11/2021

Hims & Hers Health

1/19/2021

Oscar

2/22/2021

23andMe

2/4/2021

Nightingale

3/19/2021

Owlet

2/16/2021

Alignment Healthcare

3/30/2021

Sharecare

2/15/2021

NeuroPace

4/14/2021

Sema4

2/11/2021

Waterdrop

4/16/2021

Brava Diagnostics (dba SomaLogic)

3/29/2021

Privia Health

4/28/2021

Butterfly Network

2/16/2021

Sight Sciences

6/23/2021

Science 37

5/7/2021

Erasca

6/25/2021

Babylon Health

6/3/2021

Valo Health

6/9/2021

UpHealth/ Cloudbreak

6/11/2021

Talkspace

6/23/2021

portunity to live our mission on a global scale, resolving health disparities, reshaping healthcare, and powering its digital transformation,” said Jamey Edwards, CEO of Cloudbreak Health. StartUp Health company Nightingale also went public on Nasdaq Helsinki (HEALTH. HE). Across both IPOs and SPACs we’re seeing an increasing focus on the consumer and on patient engagement, with companies like Sharecare, 23andMe, Babylon Health, and Talkspace (the first publicly traded pure-play mental health company).

68 StartUp Health Magazine / Issue 6

top investors & dry powder

So far in 2021 investment firms have raised more than $196.4B in new capital, compared to $94.7B during the same period in 2020. That’s a 107% YoY increase. That dry powder signals that health innovation investors have the ability to invest quickly, and at higher levels, to both support the increasing number of healthcare entrants seen in the marketplace as well

Top Investors Investor

Investments YTD

General Catalyst Partners

Tiger Global Management

Optum Ventures

Andreessen Horowitz

Oak HC/FT

Polaris Partners

Insight Partners

Khosla Ventures

as continue funding the winners through scale. Our list of top investors in health innovation is full of usual suspects, like General Catalyst, Tiger Global, Optum Ventures, and Andreesen Horowitz. We continue to see their deepening commitment to health innovation as these firms double down on the sector. General Catalyst raised a $600M fund this quarter.

Tiger Global raised a $6.7B fund which appears to be one of the biggest venture funds ever. conclusion

For most of a decade, we at StartUp Health have beat the same drum. Together we can achieve health moonshots, but it’s going to take a kind of investment that we’ve never dreamed possible. This report’s record funding numbers, which far eclipse last year’s banner numbers, are finally beginning to crack the surface of what we believe is possible. Another important theme in this report is the globalization of every major health innovation sector. Insurance tech saw a major raise from France-based Alan; pharmacy tech saw expansion in India with PharmEasy. Telemedicine lays new foundations in Europe with Kry’s raise, while Canadian homecare startup AlayaCare raised the kind of capital needed to expand into the US market. While this activity has been happening for years, what is significant is the investment amounts — each raise mentioned above is in the hundreds of millions, a level previously unheard of outside the US. We’re thrilled to see this trend because health moonshots know no boundaries and we have to be in this fight together. Does this report signal the beginning of a long-awaited and much-needed shift in investment priorities towards Health Moonshots and global health goals? We certainly hope so. Keep tabs on health innovation funding each week on our blog, and we’ll be back next quarter with more analysis. startuphealth.com 69

STARTUP HEALTH VINTAGES

2021 Vintage Investments BY THE NUMBERS

17 17

INVESTMENTS

ACTIVE (100%)

KAITLIN CHRISTINE CEO & Founder, Gabbi

PORTFOLIO SPOTLIGHT

Richard Bennett CEO, Epicured

Epicured is a subscription-based meal service built around a deep understanding of clinically-validated diets and the struggles patients face with using food to manage their condition. When you become an Epicured subscriber, you’ll choose from nearly 100 menu choices all tailored for your specific health needs. Every week, subscribers choose from an ever-changing, Michelin-starred chefprepared menu of vegan, vegetarian, pescatarian, and omnivore recipes that are all 100% Low-FODMAP and glutenfree. The team is currently serving about 4k patients, and around 2k of those patients are getting food with Epicured every single week.

*Data as of June 30, 2021. Sample of portfolio company investments and may not be representative of larger portfolio. See appendix for a full list of companies.

70 StartUp Health Magazine / Issue 6

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“Thank you for the great promotion and support. I landed my lead angel investor from the introduction article on the StartUp Health Media platform." -Sheena Franklin CEO & Founder, K’ept Health

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STARTUP HEALTH VINTAGES

2020 Vintage Investments BY THE NUMBERS

41 39

INVESTMENTS

ACTIVE (95%)

EVI HEILBRUNN CEO, Privy

PORTFOLIO SPOTLIGHT

Sami Inkinen CEO, Virta Health

Virta is on a mission to reverse type 2 diabetes in 100M people by 2025. Virta is a telehealth company that aims to help people manage diabetes with frequent monitoring and dietary counseling. Every entry of symptoms and data goes straight to their clinicians and information is intelligently surfaced to enable on-time medical decisions, including medication de-prescription. Virta’s one-year peer-reviewed results show diabetes reversal in 60% of completing patients, with 94% of participants reducing or eliminating insulin usage. Virta raised a $133M Series E in April 2021, valuing the company at $2B.

*Data as of June 30, 2021. Sample of portfolio company investments and may not be representative of larger portfolio. See appendix for a full list of companies.

72 StartUp Health Magazine / Issue 6

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“There’s a feeling I have as a founder that I’ve never fully appreciated before. That feeling is hope. Having StartUp Health’s support means the world to us, and with it, we’re going to change the world.” -Tim Fitzpatrick CEO & Founder, IKONA Health Confidential Information. Not for Distribution. TM & © 2021 StartUp Health Holdings, Inc. No part of this work may be reproduced without written permission from StartUp Health Holdings, Inc.

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STARTUP HEALTH VINTAGES

2019 Vintage Investments BY THE NUMBERS

55 50

INVESTMENTS

ACTIVE (91%)

RENEE RYAN CEO, Cala Health

PORTFOLIO SPOTLIGHT

Iyah Romm CEO, Cityblock Health

Founded in 2017, Cityblock Health is a transformative, value-based healthcare provider for Medicaid and lower-income Medicare beneficiaries. They partner with community-based organizations and health plans to deliver medical care, behavioral health and social services virtually, in-home and in communitybased clinics. Modern technology is at the core of the model, with custom-built tools to support care team operations and member interactions. Cityblock currently serves more than 75k members across four metro areas. In March 2021, Cityblock raised a $192M Series C extension, after closing $160M in Q4 2020.

*Data as of June 30, 2021. Sample of portfolio company investments and may not be representative of larger portfolio. See appendix for a full list of companies.

74 StartUp Health Magazine / Issue 6

HEALTHMOONSHOTS.COM

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“StartUp Health is my home base as a founder. StartUp Health has provided exposure to investors and customer that I’d never have gotten on my own. They’ve given me support to accelerate faster and with more confidence.” -Troy Bannister CEO & Founder, Particle Health Confidential Information. Not for Distribution. TM & © 2021 StartUp Health Holdings, Inc. No part of this work may be reproduced without written permission from StartUp Health Holdings, Inc.

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STARTUP HEALTH VINTAGES

2018 Vintage Investments BY THE NUMBERS

72 58 4

INVESTMENTS

ACTIVE (81%)

KEVIN DEDNER CEO & Founder, Hurdle

PORTFOLIO SPOTLIGHT

Todd Park Executive Chairman, Devoted Health

ACQUIRED (6%)

Devoted Health’s mission is to dramatically improve the health and wellbeing of seniors by taking care of each and every person like they are literally a family member. Devoted Health partners closely with primary care physicians who oversee care for all members. Devoted Health supports this care with dedicated Devoted Health Guides who, aided by their powerful technology, help members navigate the healthcare system and get the care that they need. They currently offer Medicare Advantage plans in Texas, Florida, Ohio and Arizona.

*Data as of June 30, 2021. Sample of portfolio company investments and may not be representative of larger portfolio. See appendix for a full list of companies.

76 StartUp Health Magazine / Issue 6

HEALTHMOONSHOTS.COM

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“StartUp Health is an incredible platform for education and amplification, and we’ve grown and benefited from their events, newsletters, print magazine and ongoing marketing opportunities. I’m so grateful for their partnership!” -Jill Angelo CEO & Founder, Gennev Confidential Information. Not for Distribution. TM & © 2021 StartUp Health Holdings, Inc. No part of this work may be reproduced without written permission from StartUp Health Holdings, Inc.

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STARTUP HEALTH VINTAGES

2017 Vintage Investments BY THE NUMBERS

43 26 1

INVESTMENTS

ACTIVE (60%)

ALEXANDRA GREENHILL, MD CEO, CMO & Co-founder, Careteam

PORTFOLIO SPOTLIGHT

Jamey Edwards CEO, Cloudbreak Health

ACQUIRED (2%)

Cloudbreak Health is a pioneer in telehealth technology via its video remote interpreting and language access solution, Martti, which is used across multiple specialties to improve healthcare disparities. Over 1.5M minutes of telemedicine consultation are performed each month on over 19k video endpoints at nearly 2k healthcare locations nationwide. Notable partners include Memorial Sloan Kettering, Cedars-Sinai Medical Center, Allina Health System, Providence Health & Services and Adventist HealthCare. In June 2021, Cloudbreak completed its business combinations with UpHealth, Inc. and UpHealth Holdings, Inc. The combined entity UpHealth is now traded on the NYSE under the ticker UPH.

*Data as of June 30, 2021. Sample of portfolio company investments and may not be representative of larger portfolio. See appendix for a full list of companies.

78 StartUp Health Magazine / Issue 6

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“StartUp Health is unique because it’s not an accelerator, incubator, or VC firm. It’s everything rolled into one with a global community. It’s been incredible to be put in touch with the right partners, investors and fellow entrepreneurs.” -Imran Cronk CEO & Co-founder, Ride Health Confidential Information. Not for Distribution. TM & © 2021 StartUp Health Holdings, Inc. No part of this work may be reproduced without written permission from StartUp Health Holdings, Inc.

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STARTUP HEALTH VINTAGES

2016 Vintage Investments BY THE NUMBERS

56 38 6

INVESTMENTS

ACTIVE (68%)

SATHYA ELUMALAI CEO & Co-founder, Aidar Health

PORTFOLIO SPOTLIGHT

Teemu Sunna CEO, Nightingale Health

ACQUIRED (11%)

Nightingale’s blood analysis detects early disease risks and helps people live healthier lives. Their health data platform is created by combining two scientifically strongly verified assets: a proprietary mass-scale blood analysis technology and the ability to comprehensively identify disease risks. Nightingale has 120 partnering institutions and was selected to profile the entire UK biobank collection of 500k blood samples, the entire Finnish National Biobank and the world’s largest blood-based prospective cohort study in Latin America. In March 2021, Nightingale went public on Nasdaq Helsinki, the largest Finnish First North IPO to date.

*Data as of June 30, 2021. Sample of portfolio company investments and may not be representative of larger portfolio. See appendix for a full list of companies.

80 StartUp Health Magazine / Issue 6

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“We're based in Barcelona and having access to the U.S. market is really helpful. The contacts and knowledge of the market from StartUp Health and fellow Health Transformers is incredibly useful to us.” -Cristian Pascual Co-founder, Mediktor Confidential Information. Not for Distribution. TM & © 2021 StartUp Health Holdings, Inc. No part of this work may be reproduced without written permission from StartUp Health Holdings, Inc.

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STARTUP HEALTH VINTAGES

2015 Vintage Investments BY THE NUMBERS

32 13 3

INVESTMENTS

ACTIVE (41%)

NAVYA SINGH, PsyD Co-founder, wayForward

PORTFOLIO SPOTLIGHT

Brant Herman CEO, MouthWatch

ACQUIRED (9%)

MouthWatch is on a mission to develop dental products and telehealth solutions that increase access to care, boost practice revenue and improve the dental patient experience. In addition to intraoral cameras, MouthWatch offers TeleDent®, a HIPPA-compliant proprietary teledentistry platform characterized by ease of implementation and ease of use. MouthWatch products are used in 10k US operators with 14k cameras sold to date in 50 states and 34 countries via direct sales and distributors.

*Data as of June 30, 2021. Sample of portfolio company investments and may not be representative of larger portfolio. See appendix for a full list of companies.

82 StartUp Health Magazine / Issue 6

HEALTHMOONSHOTS.COM

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“It’s powerful to have conversations with my fellow Health Transformer Circle members every month to make sure my thought process is heading in the right direction.” -Bill Nordmark CEO, Aver Confidential Information. Not for Distribution. TM & © 2021 StartUp Health Holdings, Inc. No part of this work may be reproduced without written permission from StartUp Health Holdings, Inc.

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STARTUP HEALTH VINTAGES

2014 Vintage Investments BY THE NUMBERS

37 17 5

INVESTMENTS

ACTIVE (46%)

SATISH MOVVA CEO & Founder, CarePredict

PORTFOLIO SPOTLIGHT

Murray Brozinsky CEO, Conversa

ACQUIRED (14%)

Conversa delivers personalized, automated virtual care and communication based on dynamic patient profiling in order to monitor, manage and engage populations at scale. In spring 2020 they launched a comprehensive suite of COVID-19 programs developed with top clinicians (and CDC guidance) that rapidly improves health organization’s care capacity, and provide a safe way to screen employees. Conversa’s partners include Northwell Health, University Hospitals Health System, UCSF, Davita, UNC Health, Spectrum Health and Atrium Health.

*Data as of June 30, 2021. Sample of portfolio company investments and may not be representative of larger portfolio. See appendix for a full list of companies.

84 StartUp Health Magazine / Issue 6

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“StartUp Health taps us into a global network that provides not only support but also answers, advice and intelligence. It has fast-tracked our business in a number ways.” -Lynda Brown-Ganzert CEO & Founder, Curatio Confidential Information. Not for Distribution. TM & © 2021 StartUp Health Holdings, Inc. No part of this work may be reproduced without written permission from StartUp Health Holdings, Inc.

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STARTUP HEALTH VINTAGES

2013 Vintage Investments BY THE NUMBERS

42 13 14

INVESTMENTS

ACTIVE (31%)

REED MOLLINS Co-founder, Doctor.com

PORTFOLIO SPOTLIGHT

Anish Sebastian CEO, Babyscripts

ACQUIRED (33%)

Babyscripts is the most comprehensive and clinically validated maternity program to help manage expecting moms virtually, before and after birth. The Babyscripts technology is a combination of a smartphone app and internet-connected medical devices delivered via their “Mommy Kit,” which remotely monitor patients and allows providers to risk-stratify care, offering specific experiences to manage different risk conditions (e.g. diabetes, hypertension). Babyscripts works with 70 health systems across 25 states and the District of Columbia, managing over 250k pregnancies annually.

*Data as of June 30, 2021. Sample of portfolio company investments and may not be representative of larger portfolio. See appendix for a full list of companies.

86 StartUp Health Magazine / Issue 6

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“StartUp Health is three things in one. They are the best investors I can have, the best advisors I can have, and some of the best thought partners that I can have.” -Victor Penev CEO & Founder, Edamam

startuphealth.com 87

Jonas Salk spent eight years developing a successful vaccine for polio, then refused to patent it for personal gain so that more people could access the life-saving treatment.

Dream Impossible At StartUp Health we help Health Transformers achieve health moonshots. Learn more at healthmoonshots.com Photo by Yousuf Karsh 88 StartUp Health Magazine / Issue 6