ViVE post-script: VC panel opines in midst of digital health’s new reality (depression?), and extra ViVE from an attendee

March 31, 2023 | by

Not everything at ViVE this week was fun and music. The organizers included a timely panel discussion with four VCs exploring the crash of digital health funding, enterprises, and whither the fall of the VCs’ favorite bank, Silicon Valley Bank (SVB). It was moderated by MedCityNews‘ editor-in-chief Arundhati Parmar, who published an interview with Zane Burke, late of Livongo and now CEO of Quantum Health, pointedly asking whether Livongo’s sale to Teladoc was a smart one given the troubling post-script [TTA 3 Feb]. The participants — Lee Shapiro, managing partner at 7wireVentures, Emily Melton, managing partner at Threshold Ventures, Richard Mulry, president and CEO of Northwell Holdings, and Ambar Bhattacharyya, managing partner of Maverick Ventures–evidently weren’t given a diet of softballs, either. 

Parmar started with a quote from a recent article in another publication: “The run on SVB was a textbook result of the myopia and egoism that has swallowed the venture capital industry whole.” This refers to the advice that many VCs gave their invested companies–get your money out now. That was the same invested money that the VCs insisted be in SVB, in accounts such as payables and receivables. At least these VCs seemed to realize that now, somewhat obliquely. Shapiro called it a ‘tragedy of the commons’, B-school terminology that refers to too many people using a common resource ruining it because no one is responsible for it. More to the point, he pointed to some in the VC ‘community’ advising their companies to move their money out of SVB, creating the self-fulfilling prophecy of a run on the bank killing it. Melton pointed to social media and everyone rushing to take care of themselves without reflecting on the consequences of their actions.

The next quote and chart that Parmar presented had to do with that Old Devil Profitability in companies that IPO’d. Only two of 17 are profitable and they’ll be a surprise–Privia Health (VBC models for providers), and Progyny (riding the fertility and benefits bubble). Rather abashedly, the panel admitted to valuation frothiness leading to over-valuation, and a new sobriety and realism leading to (drum roll) an emphasis on profitability. Bhattacharyya noted that VCs were pushing growth up until last year. Now, it’s value, ruled by the “Rule of 40” –combined growth rate and profit margin that exceeds 40%, even better cash flow positive, which are tough bars to achieve for all but the most well-positioned (and fortunate) companies. “That’s now the playbook. So we’ve all transitioned to that.” A defensive playbook, in Shapiro’s view. (A close to impossible one that may stifle innovation, in this Editor’s view, though bootstrapped companies have always earned her admiration.)

To that point, Melton, noted that now more than ever, banking institutions like SVB and similar institutions need to work with founders and VCs to bring innovations to market. “One of the things I’m very fearful of is that we get into an environment where people are risked off and retreat right when we need people to be actually leaning in more now than ever.” Larger banks will be happy to take the money–according to Kruze Consulting, an accounting firm that focuses on startups, about half of its clients that recently changed banks moved to JPMorgan Chase–but will a JPM take up ongoing startup risk? 

Does this begin to feel like Catch-22? (Apologies to Joseph Heller) Or health tech back around 2006-2010?  

One comment towards the end hit home for this Editor, having seen it way up close. Too many founders 1) have an idealistic view of the business they started and can’t separate from it, and 2) there’s a time to exit stage left and do something else with your life. One company that may pull it off in its changeover of CEOs is Oscar Health. I’d add that no CEO should be in that seat for more than 5 years, even in well-established, doing-well companies–much less coming close to dying in place as CEO after 25 years as happened recently at one large, publicly traded payer. Very important: every company should have a succession/coverage plan operative from Day 1, because Stuff Happens. The full article in MedCityNews here. Another shorter take, same panel, in Mobihealthnews.

The next chapter for SVB is that after a Federal bailout (and the realization that the SF Federal Reserve was wearing blinders when it came to watchdogging the bank’s health and solvency), it was mostly sold this past week to First Citizens Bank & Trust Company, a regional bank from Raleigh, North Carolina. SVB’s UK holdings were bought much earlier by HSBC. Also up for sale: Leerink Partners, an investment banker for health care and life sciences companies, that was rebranded as SVB Securities. Jeff Leerink, the founder who still heads it, is trying to get it back through a management buyout. WBUR

A more ViVEcious view of the meeting is over at HISTalk, The most substantive sessions this attendee heard were the opening Tuesday by Micky Tripathi, the National Coordinator for HIT at the Office of the National Coordinator (ONC) for Health Information Technology, and a presentation by Shiv Rao (Abridge) and Joon Lee (UPMC) on generative AI. The downside was that most of the Tuesday presentations came off like walking ads, the CHIME track was separate with some members-only, and that exhibitors got little value by staying over Wednesday as the crowd vanished to 20%. Money quote: “ViVE shoots for a vibe of youth, energy, innovation, and fun in its branding, themes, opening remarks, and evening entertainment. Sounds great until you remember that your ticket cost nearly $3,000.” Ouch! That stings! Well, nobody’s perfect. A successful 2023 means that ViVE will be landing in Los Angeles 25-28 February 2024. For many, it’s on to HIMSS23 in a couple of weeks.

A new event–and not all virtual! HLTH and CHIME to launch ViVE in March 2022.

April 21, 2021 | by

Does it seem like forever that there’s been a new digital health conference, fully in-person–and not labeled HIMSS? HLTH, a relatively new entrant to the big healthcare event calendar starting in 2018 in Las Vegas, and CHIME, The College of Healthcare Information Management Executives, will launch ViVE on 6-9 March 2022 at a location (TBD) in Miami Beach. They are positioning it as an annual event for digital health leaders innovating across the spectrum of health and care. 

The event will incorporate CHIME’s spring forum, a full plate of networking events and presentations, matchmaking, the ViVE Expo, and a gala. For more information on the event or to register interest as a sponsor or partner, see the ViVE page. Release. 

(This Editor admits that the thought of a new and in-person conference is exciting. It’s nice to contemplate normality!)

CHIME is a 5,000-member association of C-level and senior healthcare IT leaders across 56 countries. The organization parted from the annual HIMSS event this year in Las Vegas 9-13 August, which will be a hybrid in-person and virtual conference [TTA 4 Feb]. Registration and information on the event have been updated.

The HLTH 2021 next event is in Boston 17-20 October. Like HIMSS, it’s scheduled to be a combination in-person and virtual event. HLTH is more broadly inclusive of healthcare care models and consumer health issues. The in-person portion will be at the Boston Convention & Exhibition Center, located in the Seaport District. 

Short takes, 4 Feb: HIMSS 21 Global/APAC go ‘hybrid’; ATA announcements including virtual ATA2021; Hillrom acquires EarlySense monitoring tech

February 4, 2021 | by

It’s 4 Feb, and while All Is Not Right With the World, we should be reassured that a real, in-person HIMSS 21 Global conference is apparently still On Target for 9-13 August in Las Vegas. What’s new is that it will have a virtual component (the ‘hybrid’) in addition to the Three Ring Circus spread among the Venetian-Sands Expo Center, Caesars Forum Conference Center, and the Wynn. t Hotel reservations ARE open, but registration is not. (Those who wish to transfer the 2020 registrations to 2021 will have to wait for an email.) HISTalk, which always seems to have the Inside Line on the conference, confirmed that HIMSS is kicking the can down the road on an in-person conference. It’ll depend on vaccination rates, infection rates, and federal guidelines, all of which are indefinable bars to something six months down the road. The next HIMSS21 update will be published on 19 February. It may include an announcement of the registration opening date. As the HIMSS update page is singularly uninformative, this Editor is subscribing to their update emails as offered.

Reading further down on HISTalk, the long-standing co-located CHIME (College of Healthcare Information Management Executives) annual conference is no more. CHIME will be holding a hybrid Fall Forum in October and virtual events in April and June. Will this mean that a lot of CIOs and senior IT people–the deciders–will not be as eager to go to Las Vegas and HIMSS will turn even more into a ‘boat show’, in HISTalk’s words? 

Meanwhile, in Singapore on 18-19 May, HIMSS APAC is full hybrid with both in-person and virtual sessions. The theme is Future-Proof Healthcare: The Emergence of Asia. If you’d like to nab a speaking or panel spot, act fast–it closes on 28 February and is only open to government/healthcare providers. More info is on their website.

The American Telemedicine Association just wrapped its four-part ATA EDGE virtual conference. Like a lot of virtual events, it’s split into relatively short sessions (about 2.5 hours) and multiple days. EDGE was on Tuesdays starting 12 January and wrapped 2 February. Announcements and related news from EDGE and ATA include an announcement for ATA2021:

  • The Telehealth Equity Coalition (TEC) launched. TEC is a data-driven project to review public data on telehealth adoption in communities across the country. The objective is “to improve access to quality and affordable healthcare by increasing adoption of telehealth, especially among those who have been left out or left behind. Together with nonprofit, academic, and industry partners, TEC will offer a unique voice to optimize equitable telehealth delivery and utilization.” Founding members are Hims & Hers, the ATA, and the National Health IT Collaborative for the Underserved. Release
  • ATA2021 will be full virtual in June and take place on Tuesdays and Thursdays. This year’s theme is Telehealth: Enabling Flexible, Inclusive and Contemporary Care Delivery. More information on the content and program, including links to proposal submission forms, is here. Deadline for General Program speaker nominations and Research Presentations/Posters is 26 February. The registration page is not yet active.
  • On the policy front, ATA commended Texas Governor Greg Abbott on his advocacy of telehealth expansion as key to quality care for Texans. In his State of the State annual address, he outlined goals for the executive and the legislature in expanding both telehealth and broadband access. Release  ATA also sent a letter to the Arizona State Legislature in support of House Bill 2454 which makes some comprehensive changes to telehealth policy that will increase telehealth options in that state. Letter

And in the Continuing Story of Big Company Buys Little Company’s Tech, Hillrom, which just acquired cardiac monitoring company BardyDx, has now acquired contact-free continuous monitoring technology from EarlySense. Hillrom already has equity in the Massachusetts and Israel-based company. A portion will go in payment for the monitoring technology, plus a cash consideration of $30 million with potential payments based on the achievement of certain commercial milestones. EarlySense will also have a license to the technology, useful as EarlySense continues to develop next-generation AI-based sensing technologies specifically for the remote patient care market. Hillrom is incorporating it in its Centrella Smart+ med-surg bed and ecosystem of connected devices for the monitoring of heart and respiratory rates over 100 times per minute. Release 

Breaking News: HIMSS20 canceled; Naidex update; what is the outlook for other major conferences? (updated)

March 5, 2020 | by | 2 Comments

UPDATED 5 and 12 March

At 12.25 pm today, according to an email visible on HISTalk, HIMSS has canceled HIMSS20. This cancellation is the first in the 58-year history of the conference.

Quick facts are on HISTalk at the link above, on the HIMSS announcement, and on their FAQs.

The advisory panel recognized that industry understanding of the potential reach of the virus has changed significantly in the last 24 hours, which has made it impossible to accurately assess risk. Additionally, there are concerns about disproportionate risk to the healthcare system given the unique medical profile of Global Conference attendees and the consequences of potentially displacing healthcare workers during a critical time, as well as stressing the local health systems were there to be an adverse event.

Also from the announcement: “HIMSS20 exhibitors and attendees will be contacted with further information regarding booth contracts and registrations. Please contact exhibitors@himss.org for immediate booth concerns.”

The CHIME (College of Healthcare Information Management Executives)/HIMSS CIO Forum symposium on Sunday 8th-Monday 9th is also canceled, per a comment on HISTalk. The only indicator on their website as of now is a large ‘CANCELLED’ on their event list. Later this month is the 5G Executive Forum on 25-26 March in Plano, Texas; is that now being reevaluated?

Neither will be rescheduled for this year. Further chatter on the 3/6 HISTalk centers on what to do with all the promotional items and after-action assessments of losses to marketing and sales. There are companies which center their annual budget and marketing efforts on HIMSS, perhaps not the best ‘eggs in one basket’ strategy, but one that many follow. Hat tip to HISTalk and their ace staff

For our UK and European Readers, Naidex is one of the largest conferences for independent living and healthcare. So far, it is on at Birmingham NEC from 17–18 March, they are taking a long list of precautions based on guidelines set by the WHO and local authorities, but according to their site statement by the event director, it is a fast-moving situation and may change based on those advisories. POSTPONED 10 March–see 12 March update.

Original article follows:

There is a growing list of exhibitor and attendee cancellations for HIMSS20 in Orlando, Florida, starting next Monday the 9th. HIMSS is one of the largest global healthcare conferences, and is a ‘must attend’ for a wide swath of healthcare-related companies, including clinical and monitoring technologies, software from the giants (Microsoft, Cisco) to the startups, hospital systems, payers, telecoms, and all sorts of governmental entities like CMS. (When the opening keynote speaker is President Trump, you know it’s important.)

Health IT website HISTalk, a regular exhibitor at HIMSS, has been tracking the cancellations as of today, doing their own research and following reader leads and public announcements, with a follow up article dated tomorrow. It’s well above 50, with major companies like Humana, Siemens, IBM, and the aforementioned Cisco and Microsoft, on the list. Modern Healthcare has an update.

Based on the comments and HIMSS’ own advisory, HIMSS is accepting cancellations from the CDC’s Level 3 or 4 alert countries, but other cancellations are not being refunded (likely pushed to 2021). Hotels/airlines may not be refundable based upon policies and the clout of travel bookers. Onsite, HIMSS is preparing onsite medical offices for care and screening, as well as promoting the HIMSS elbow bump in lieu of the handshake. It’s regrettable as there are hundreds of staff involved year to year who are responsible for all the planning, marketing, logistics, and security for HIMSS and any conference of this size.

The major reason? Many companies, including healthcare companies, have indefinitely canceled non-essential travel across the board for the next 30 to 60 days as a matter of institutional policy. The large destination conferences taking place March-June are the most affected by this. Consider that for the immunocompromised, attending any large conference is dicey, but COVID-19 is one large red flag.

IBM has canceled Think 2020 in May, which regularly attracts 30,000 attendees to San Francisco. Mobile World Congress Barcelona, the largest in the telecom sector which crosses over to mobile-based healthcare, canceled two weeks before starting on 24 February. The American Physical Society (physics) canceled this week’s conference in Denver the day before it started. The LA Times has a roll call of canceled conferences including Facebook and Google I/O. Others remain on, but monitoring the situation:  the American College of Healthcare Executives Congress on 23 March and EPIC 2020 in Croatia 19-21 March [TTA 16 Jan].

Small, local conferences and meetings are the least affected, so you’re probably safe in London and NYC. The King’s Fund has a full roster of London meetings, including the Digital Health and Care Congress 2020 on 20-21 May. Upcoming are also DHACA Day on 18 March and the NYC meetings listed last week. (Don’t go if you’re sick, steer clear of the inconsiderate, avoid buffets, and wash your hands!)

HISTalk’s 5 March article (scroll down) reports on the findings from the leader of the WHO team which spent two weeks in China studying their COVID-19 response. China is moving patients from their best hospitals to ‘routine care’ to accommodate COVID-19 patients. Children do not seem to become infected or be carriers. The trend in infection there is trending down. Overall, it seems to be a series of global outbreaks, not a global pandemic. And they came away with a fatality rate in China of 1-2 percent, which seems low based on other reports.

VA’s ‘Anywhere to Anywhere’ telehealth initiative finalizes

May 24, 2018 | by

VA Secretaries may come and go (or never get there), but their initiatives stay. With much fanfare last year, then-Secretary David Shulkin announced the ‘Anywhere to Anywhere’ telehealth and telemedicine program [TTA 3 Aug]. This program will use VA practitioners to provide virtual patient care across state lines when a veteran cannot make it to a VA hospital or clinic. The Department of Veterans Affairs published the proposed rule last October [TTA 3 Oct 17] with the Final Rule published in the Federal Register on 11 May.

Technically, it preempts state and local regulations around telehealth. “VA is exercising Federal preemption of conflicting State laws relating to the practice of healthcare providers; laws, rules, regulations, or other requirements are preempted to the extent such State laws conflict with the ability of VA health care providers to engage in the practice of telehealth while acting within the scope of their VA employment.”

It was widely supported by ATA, the American Association of Family Physicians, American Medical Informatics Association, Federal Trade Commission, the College of Healthcare Information Management Executives (CHIME), and many other industry organizations. It also enjoys wide Congressional support.

There is plenty of room for growth. Only 1 percent of VA’s veterans used Home Telehealth, while 12 percent used other forms of telehealth. They will be doing so with few suppliers: Medtronic, 1Vision/AMC Health, and Care Innovations. Iron Bow/Vivify Health was found to not have tablets which met the US production qualification. This Editor wonders how the current three suppliers will fare.

This telehealth program will be located in the apparently newly named Veterans Health Administration Office of Connected Care. mHealthIntelligence.com