Weekend reading: Forbes picks the next $1B startups, is TV streaming analogous to the future of healthcare?

August 18, 2023 | by

Will we have any more unicorn startups? Forbes seems to think we will and picked out 25 with TrueBridge Capital Partners. They’re a potpourri of cybersecurity, ID fraud, IT, fashion, financial, farming, and even an aircraft company. Only a few are healthcare-related and Becker’s picked them out:

Chapter, co-founded by Republican Party presidential hopeful Vivek Ramaswamy. uses its database to fit the best Medicare plan options (Medicare Advantage, supplements) to individuals. Unlike brokers, their consultants get paid the same no matter the plan. It’s raised $61 million and has revenue of $15 million.

Medallion does the dog work of verifying medical licenses and enrolling doctors in insurance networks. They have more than 300 customers, including Oak Street Health and VillageMD. It’s raised $85 million   and has revenue of $13 million.

Pendulum Therapeutics is in microbiomes–gut health–and what early usage can produce over a lifetime. Many babies given antibiotics have now been found to be more susceptible to chronic lifelong problems that include asthma, ADHD, diabetes, and celiac disease. Its flagship is a glucose-control pro­biotic for mana­ging Type 2 diabetes. It’s raised $116 million and has revenue of $11 million.

Verifiable verifies the credentials of medical professionals using machine tools. It’s raised $47 million and has revenue of $6 million.

Is there a usable analogy between the TV streaming wars and healthcare’s future? This essay in Becker’s Hospital Review is unusual for them. It draws a line between the fragmentation, redundancy, and overlap in entertainment that streaming services such as Hulu, Disney+, and Netflix have created, to the fragmentation, redundancy, and overlap between health systems and health companies such as Optum, Humana, CVS Health, Walgreens, and even Amazon in taking care away from the hospital setting into clinics and the home, breaking the centralized hold that health systems have had on patients. Too much á la carte, confusing, and fragmented for patients at usually a very bad time, unlike sitting on the couch and wondering which home improvement or celebrity reality show to watch.

The Theranos Story, ch. 32: 155 employees out in latest layoffs, 220 left to go

January 9, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/04/Yak_52__G-CBSS_FLAT_SPIN.jpg” thumb_width=”150″ /]Endlessly, flatly spinning, towards Ground Zero…. As a marketing person made redundant (US=laid off) for various reasons by companies (moving out of area, acquisition, dissolution, etc.), this Editor has zero joy in reporting that 155 Theranos employees will be discharged as it “re-engineers its operations” “towards commercialization of the miniLab testing platform and its related technologies” “aligned to meet product development, regulatory and commercial milestones.” Their Friday press release successfully buried itself on a weekend, aided by a tragic Heaping Helping of Bad News out of Fort Lauderdale. The rationale is that this is justified to better position itself to commercialize the miniLab and “related technologies”. The miniLab reportedly is a compact, microwave-sized lab that automates small volume samples by sending them for analysis to a central server which would do the full analysis, thus driving down cost and time.

Theranos is a company flailing. This Editor notes in its string of releases an endless emphasis on compliance, regulation and operational expertise, the kind of attitude and caution that should have been present years ago. The layoffs follow on last October’s involuntary exits of 340 employees and lab closings (Chapter 21). Run the numbers and there are 220 employees left to go. Will the miniLab, seemingly hastily concocted, be their salvation? Flip back to our Chapter 18 about the October AACC meeting.  Chemical laboratory professionals were distinctly underwhelmed by the miniLab and CEO Elizabeth Holmes’ presentation. Also not boding well was Theranos’ withdrawal of a miniLab Zika test FDA emergency clearance in late August, at the height of the crisis. What may be wafting is the aroma of performing seals on a hot day.

Speaking of leadership, is Ms Holmes among the fired or demoted? Highly unlikely as she controls all $9 of the company’s formerly $9 bn Unicorn Worth. Is she even taking a pay cut? Will you see her out in front of Palo Alto HQ mowing the long grass?

To nearly 500 people now wondering about their livelihood in one of the most expensive areas of the US, how damaged they will be by their association with Theranos? Despite the ‘fail fast’ mantra of Silicon Valley, there’s little tolerance by employers for those at the operational level having a failed company in their past. These people should have our empathy, not ‘guilt by association’, and as appropriate, respect for their skills which were badly used in their last situation.

One also wonders how long it will take before there is another Chapter in The Theranos Story, one that they will file via one of their multitudinous law firms–Chapter 11. Consumerist (Consumer Reports), Yahoo News.

See here for the 31 previous TTA chapters in this Continuing, Consistently Amazing Saga, including the resignation of General Mattis from the BOD (Ch. 31), Theranos’ annus horribilis (Ch. 30) and the law firm feeding frenzy (Ch. 29).

The Theranos Story, ch. 20: How Arizonans fell hard and let Theranos change health policy

September 15, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/upside-down-duck.jpg” thumb_width=”150″ /]The face is in the lake, and the yellow duck is upside down–augering in! A flatly-spinning Yak-52 no longer describes the glide path of Theranos, now at value 0. So as the dust settles, the Tales of When The Circus Came to Town are dusted off and published. Here Tim Steller, a writer and columnist with the Arizona Daily Star, reminisces on those dazzling Arizona days back in March 2015–18 short months ago–when Elizabeth Holmes swept into Phoenix in her bodyguarded SUV, trailing lobbyists and dropping names. The state legislature and Governor Doug Ducey, by this telling, were mere putty in her hands, star-struck into approving a bill permitting direct consumer ordering of lab tests, over the objections of the Arizona Medical Association and the questioning of the two doctors in the legislature. The Big Question–“does your blood-testing technology work?”–never was asked, and only two voted against the bill. At least Theranos only sought deregulation to facilitate its placement in Walgreens; Zenefits, another one-time Unicorn, gained employment incentives for its online HR-benefits brokerage, which were voided with recent layoffs. Tucson.com  See here for the 19 previous TTA chapters.

If Silicon Valley were a rose, it would be wilting

February 20, 2016 | by

Does this signal a new ‘trough of disillusionment’? The lead in this story is one of the major practice EHRs in the US–Practice Fusion. From a high valuation in 2013 of $635 million as a healthcare darling (free to doctors, ad supported), it burned through $4 million cash per month while revenue missed targets by 10 percent, chased after rainbows such as telemedicine, overhired, overperked and overpartied in the office. Now with a quarter of their staff pink-slipped, a new CEO is trying to bail them out. Most of the other examples aren’t healthcare, but huge deals by VCs are slowing, companies are discounting the price of their shares, taking on debt to not dilute shares, laying off employees and subletting their space. Adding to this is the glut in wearables and a slowdown in demand for single-purpose devices, leading to a 20 percent loss today in value in shares of Fitbit (MarketWatch). Like the ‘oil patch’ in the upper Midwest, the San Francisco area is feeling the chill that never really left the rest of the country. And ‘unicorns’ may become an endangered species. Wall Street Journal

A deserved goring of whiz-bang unicorns Theranos and Zenefits (updated)

February 17, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/1107_unicorn_head_mask_inuse.jpg” thumb_width=”150″ /]A blog posting this Editor wish she had written. Fred Goldstein, who is a consultant to healthcare systems focused on building accountability and improving population health, has pressed a sharp point to the sparkly bubbles surrounding two Silicon Valley billion-dollar valuation darlings, Theranos and Zenefits, on their playing fast and loose with basic regulations.

Some background for our readers. It’s a pile-on with Theranos, which has been stepped on by FDA for their nanotainers [TTA 20 Nov 15], then whacked by the Centers for Medicare and Medicaid Services (CMS) last month for ‘deficient practices’ at their California testing lab (a remedial plan has been filed this week) and likely losing its lucrative Walgreens Boots deal if problems aren’t fixed in 30 days (having already lost its program with Capital Blue Cross in the Harrisburg area of Pennsylvania). According to Bloomberg, its proprietary testing is now used in only 1 of every 200 tests. Zenefits claims to be the ‘first modern benefits broker’ with cloud-based software designed to simplify and automate such HR tasks as health insurance signups for small businesses, but its software that facilitated skating around required licensure requirements by its staff got its CEO forced out by a key investor, Andreessen Horowitz. (And it gets worse…read on….)

It’s so…whiz-bang! (Updated) Your Editors, past and present, have made hash (corned beef and otherwise) of companies promising revolutions in healthcare since our inception. ‘Whiz bang’ (more…)

HealthSpot files for Chapter 7 liquidation (updated)

January 19, 2016 | by

The shock continues with HealthSpot. On Wednesday the company filed for Chapter 7 liquidation in US Bankruptcy Court for the Southern District of Ohio in Columbus. The laundry list: assets of $5.2 million, about $3.5 million in inventory, and $23.3 million in liabilities, including convertible notes of $10 million from cable/broadband company Cox Communications, $6 million from investor Xerox and an undisclosed amount from the Ohio Development Services Agency. HealthSpot had raised close to $44 million since 2011. Their bankruptcy attorney David Whittaker cited cash flow; with only $1.1 million in revenue over the past three years, according to the filing, including $600,000 in 2015, no elaboration was needed. There’s not much left in assets to sell: 191 kiosks, mostly in storage (137) and 54 operating but shuttered at customer sites. The remaining value in liquidation (a/k/a pennies on the dollar) is dependent on whether the name, the kiosks and the IP are purchased. The last is problematic due to the current legal action by Computerized Screening [TTA 8 Jan] We hope this is not a sad harbinger of digital health in 2016, though we have already sensed that the unicorns are heading Over The Rainbow or wherever they go to pasture, but it’s not reassuring. Columbus Business First, MedCityNews.

Update: Neil Versel in his Throwback Thursday took a look at HealthSpot’s steak and salad days at International CES 2013. (See comments for this Editor’s impressions of HealthSpot at ATA 2014.) Perhaps good marketing, but symptomatic of the capital burn, doomed by a lack of sales and quite possibly, a solution that would have knocked it out of the park in 2010. As the old fighter pilot said, ‘timing and luck are everything.’

Rounding up the funding rounds of 2015–and the deals some would like to see (?)

December 30, 2015 | by

Mobihealthnews rounded up 2015’s hot funding in the mobile health/health tech-related space, with helpful links to their articles. They cite as we have previously [TTA 16 Dec] Rock Health‘s flattish year-to-year 2015 total of $4.3 bn, but also StartUp Health’s bloom-off-rose 2015 digital health total of $5.8 bn–larger than Rock Health’s tote, but 17 percent off their 2014 total of $7 bn. If you consider the proportions: the top 10 deals raised $738 million–$130 million alone to the endlessly funded but yet to take over the world ZocDoc –the roster below $20m remains the longest, which is completely in accord with the lower part of Rock Health’s pyramid of angel-A-B rounds.

Yet Aditi Pai’s detailed summary strikes this Editor as useful in an unanticipated way. There is a certain sameness in the products and services of these companies, as if funders are seeking validation in similarity. ZocDoc, DoctoLib and Vitals–doctor profiles and appointment booking. Sharecare, Welltok, Novu, Noom, AbilTo, SocialWellth, Health Recovery Solutions, Jiff–health and wellness engagement programs/apps, many for corporate programs. Whoop, Sano, Sproutling, TuringSensor, Valencell, Moff and four others–wearables. Hello, Sleepace, Sproutling (baby)–sleep tracking. Klara, SkinVision, Spruce–dermatology apps. Beyond the gloomy forecast for unicorns (Theranos being the Child on the Milk Carton), how many of these corporate wellness programs, sleep trackers and wearables will be around in 2017? Mobihealthnews’ 2015 funding roundup.

MedCityNews takes a lighter-hearted (I think) look at 2016 deals. IBM would buy athenahealth mainly for its EHR and practice management data, plus data aggregator Validic, to beef up Watson; 23andMe, past its two years of troubles after stepping on FDA Superman’s cape, would buy PatientsLikeMe (endangering its community shaped credibility? 23PatientsLikeMe?) and the best–Theranos bought by Boston Heart Diagnostics/Eurofin (EU lab testing giant), which would reduce this unicorn to a pony…but one that might make it. Theranos also made VentureBeat’s list of Likely Carcasses in the Valley of Unicorn Death (to quote the article’s author). Chris Seper’s Deals He’d Like To See.