What’s Your Exit Strategy?

What’s your exit strategy? We’re fundraising , so I’ve been hearing this question a lot. I understand the need for both the question and my answer since I’m asking an investor for money, but it’s funny to me to think about an exit when I’m building and planning an entry. Either way, starting and exiting go hand in hand.

I prefer to think about building something that’s of value to customers. Specifically, something of enough value to get customers to pay for it. If we can succeed in that in healthcare, we’ll build something that’s very likely valuable to a much larger company. Healthcare is full of very large companies, many of which innovate through acquisition of smaller companies.

I spoke a few weeks ago at a meeting of Healthcare.MN. As I was putting together my slides, I went back through an older presentation I did done at a conference three years ago. I found a slide that included icons for many of the startups in healthcare at that time and some that weren’t startups. There has been a lot of acquisition and funding activity.

startup.icons

Looking at the list:

  • Vitality. We all remember GlowCaps, the smart pill bottle top. It had a great angle and some research behind it. Then it was acquired and rolled up into NantWorks. I haven’t heard or seen anything about GlowCaps recently.
  • MS HealthVault. MS won the PHR war with Google when Google Health shut down. MS is making some strides with the PHR through partnerships with large entities.
  • Castlight. I’m still a bit baffled by Castlight. It has raised tons of money ($160 million?) to help employers with tools for health cost transparency; but it’s hard to gauge its traction.
  • ZocDoc. Another prolific fundraiser with $100 million in equity and recently another $55 million in debt. Selling door to door with docs is an expensive endeavor. ZocDoc has expanded into all major cities.
  • MedApps. Alere acquired MedApps under what I assume  was a bit of a fire sale.
  • Zeo. The sleep headband, an early quantified self product. Zeo had evidence and a good product, but ultimately went out of business. I don’t know if its failure was direct to consumers or to sleep centers for doing home sleep testing.
  • Fitbit. Fitbit and its activity tracking wristband has become the poster child for quantified self. It also just raised $43 million and is running pilots with several payers.
  • iTriage. It was acquired by Aetna is now a part of CarePass. iTriage has also gotten a ton of great press from HHS as an example app.
  • Withings. Withings has raised money and expanded its offerings to include a scale, baby monitor, and blood pressure cuff. I was on the Apple Store website recently and noticed that Withings products were listed several times on the main store page, which is impressive.
  • Runkeeper. It made waves when it alluded that its health graph would fill in where Google Health left off. It has raised money and been busy integrating additional health and wellness services.
  • Keas. Keas started as a marketplace for consumers to find care plans, then pivoted to gaming instead.
  • cakehealth. A Rock Health company, cake is now a part of PracticeFusion, though I’m not sure how it is being used. Maybe it is a part of PatientFusion as a price transparency tool for patients booking appointments.
  • CareCloud. It’s expanded beyond practice management to include an EMR and app store model. It’s been getting great press, raising money, and growing fast.
  • Epocrates. It went public then was acquired by athenahealth.
  • Kareo. A practice management company that continues to have success and recently raised money, $20 million I think.
  • Doximity. The network for physicians has grown to close to 200,000 users. Apparently the honorarium revenue model has been working well.
  • PracticeFusion. It continues to grow and get good press. It keeps talking about its API and has been integrating third parties, most recently Ring-a-doc. It also launched PatientFusion as a direct competitor to ZocDoc. It acquired 100Plus to create more tools for patient engagement.
  • VisualDx. It has grown a ton, is in most academic centers, and is rapidly expanding beyond dermatology into more general clinical decision support.
  • Medicity. An HIE vendor, it was acquired by Aetna and is now a part of the Healthagen family, as is iTriage above.
  • dbMotion. Another HIE vendor, it was acquired by Allscripts.
  • greatcall. Mobile phones for old people, as I endearingly like to call it. It has added health-related services for things like medication adherence.

That was a fun dump of the last few years for me. The main point is that there has been a ton of activity in the health IT space, both with larger vendors and with startups. The neat thing is you could replace all of those icons with a whole new set of icons from the last few years. I wanted to write more about the Medtronic acquisition of Cardiocom, but that was a bit off topic. More on that next.

My last post addressed APIs in healthcare and my interested in a usable catalog of them. Thanks to everybody who emailed me information. I’m still looking for healthcare APIs and would love to hear from readers.

TGphoto

Travis Good is an MD/MBA involved with health IT startups. More about me.

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