NEW @ THCB PRESS: Surviving Workplace Wellness. Spring 2014. Al Lewis and Vik Khanna. e-book edition. # INNOVATION: PCORI APP Challenge

Practice Fusion


Last year was a banner year for digital health, as the market saw significant growth in funding, bigger deals and new investors entering the space. So what’s in store for 2013? According to a survey of nearly 140 digital health entrepreneurs and over 50 health care information technology venture investors, conducted by my venture capital firm InterWest Partners, we are in for another exciting ride this year. In the survey, we asked which sectors will see the most love from investors in 2013; which companies (if any) will see a $1 billion valuation; where they are having trouble recruiting; and which digital health entrepreneur would win “Survivor: HCIT Island” The answers? Well, it all depends who you ask.

Continue reading “Investors Are from Mars. Entrepreneurs Are from Venus”

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Practice Fusion, Castlight or ZocDoc will be the next digital health IPO. That’s according to a survey of over 100 innovative digital health entrepreneurs, conducted by my firm, InterWest Partners.

Nearly one third of respondents said Practice Fusion was most likely to be the next digital health IPO with approximately 20% of entrepreneurs voting for Castlight and ZocDoc, respectively.    Among the trio, all three have been impressive generating media coverage and raising money (collectively raising over $320m in the last 2 years alone with valuations ranging from $450m to upwards of three quarters of a billion dollars), in addition to having some of the most visionary leaders in the space.

Contrary to popular belief that digital health is primarily about the next iPhone app for weight loss, sleep or exercise, it was interesting to note that all of the leading “IPO” candidates in our survey have B2B models.  This is consistent with an insightful RockHealth report ( which found that nearly 80% of digital health companies have B2B models.   Future growth in this category is likely to continue as the leading healthcare accelerators such as RockHealth, BluePrint Health and Healthbox are all seeing more applications from B2B companies.

The responses to the IPO question reflect an interesting industry trend.  Though often classified as “B2B”, many of the leading digital health companies are really B2B2C – meaning that without the C there is no B2B.   Pricing transparency tools (Castlight), scheduling platforms (ZocDoc), employer based wellness programs, medication adherence solutions – they all must find a way to engage the end user or they won’t be purchased by the employer, physician, healthplan, hospital, or pharma company.    And though it’s impossible these days to sit through a day of pitches without hearing the phrase “consumer engagement” twenty times, I’m excited that people are starting to ask more of the right questions.  Why will someone want to use this?  Does it really solve a true need?  Is the product easy to use, intuitive, and fun? Continue reading “The Next Digital Health IPO?”

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According to CMS, through May of this year, 2,400 hospitals and 110,000 eligible professionals have received $5.7 billion in incentive payments for ensuring meaningful use of electronic health records, representing about half of all eligible hospitals and about 20% of all eligible providers.

Despite this widespread adoption EHRs, reliable market share data by vendor is still very hard to come by.  So, when CMS recently updated its attestation data for midyear 2012, we took notice.  Attestation, remember, is the process by which practitioners legally verify that they have used an EHR in way that merits one of those incentive payments.  The data set includes more than 77,000 different attestations from 2011 through May of 2012 (note that it is not immediately clear why the data set has different totals than the CMS press release).

The sheer number of options for hospitals and providers stood out to us immediately.  There are 405 separate EHR vendors that hospitals or providers have used to attest to meaningful use, with 336 of these providing ambulatory EHR products.  It’s worth pausing here to note that by our count of the data found on the CMS Certified Health IT Product List, there are more than 550 separate ambulatory vendors with complete EHRs approved by CMS, meaning that despite the huge number of options, there were still well over 200 approved ambulatory vendors that have not had a single user qualify for an incentive payment yet!

Despite this enormous number of options, users attesting were fairly concentrated in the top vendors.  Of these 336, the top 15 vendors represented 75% of all providers attesting.  On the inpatient side, this concentration was even more pronounced, with the top 6 representing 75% of the total hospital attestations.

When we organize and dig into the data, a few other points stand out.

Continue reading “Numbers Don’t Lie — The EHR Market Must Consolidate”

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Everyone is always asking me what it is like being an EIR and why I decided to do it after my 5+ years working on Google Health.  First of all, for those of you who are not familiar with the term – an EIR stands for either Entrepreneur in Residence or Executive in Residence.  In the case of Morgenthaler Ventures, they were looking for a person with extensive experience in the Health IT sector at an executive level. This differs from a more traditional EIR title (entrepreneur in residence) where you are asked to incubate a startup from scratch with some support and resources.  As an Executive in Residence, I work hand in hand with the firm’s partners to author the current health IT investing thesis, map out the industry, source companies that match our areas of interest, and help with diligence. The goal of my EIR term is to find a company that Morgenthaler can invest in and then join that company as part of the executive team. I picked Morgenthaler Ventures because of their track record in health IT (invested in Practice Fusion before Health IT was in vogue) and their leadership in the industry with the creation of the first DC to VC conference.

In its 3rd year, DC to VC was initially started by Rebecca Lynn, IT Partner at Morgenthaler Ventures to bring the venture capital community together with Washington D.C. policymakers.  This year, I am proud to say that I am co-directing the DC to VC event and the health IT startup contest along with Matthew Holt and Indu Subaiya from Health 2.0. The contest will take place on the last day of the 2012 Health 2.0 Annual Fall conference in San Francisco on October 10, 2012.  Online applications open today, June 4, 2012 and stay open until August 3, 2012.

Continue reading “A Life in the Day of an EIR: Health IT Ain’t No Bubble for Venture Capital (…. so apply for the DC to VC Health IT startup showcase)”

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We’ve been keeping tabs on Practice Fusion since the early days and THCB regulars will have noticed several comments and an article from CMO Robert Rowley. CEO Ryan Howard’s been hinting for a while that they were going to be getting into bed with a major software player, that shared their SaaS approach, and today they announced an investment from Salesforce.com, who we also know has been sniffing around health care too. This will include Practice Fusion becoming part of the Force.com (kind of an app store for the Salesforce.com ecosystem, although my guess is that few physicians are going there right now to look for records (not sure they’re going to Wal-mart either, though)

Practice Fusion is claiming that 19,000 users are already on its system which includes basic practice management, as well as a pretty complex EMR workflow. Coming soon will be a greater ability to share information with patients and other physicians over the platform—which allows it to spread via viral marketing. i.e. I’m referring you this patient, click here to get their data and sign up for this free EMR too. It’s not yet CCHIT certified, but Howard is aiming to be eligible for “meaningful use” money when the criteria are finally established. Continue reading “Practice Fusion gets investment from Salesforce.com”

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MASTHEAD


Matthew Holt
Founder & Publisher

John Irvine
Executive Editor

Jonathan Halvorson
Editor

Alex Epstein
Director of Digital Media

Munia Mitra, MD
Chief Medical Officer

Vikram Khanna
Editor-At-Large, Wellness

Maithri Vangala
Associate Editor

Michael Millenson
Contributing Editor










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