Michael Esquivel

As I said right at the start of this week's The Heart of Healthcare Podcast, Shivdev Rao is one of the most exceptional founders I have ever worked with. He is also a great human being. In this week's episode he shares what is it like leading the 🚀 that is Abridge and some awesome life lessons. IMHO this is a great listen for founders building in both the AI and healthcare fields!

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A little self-serving as an IP attorney but can’t disagree with Howard Levin’s take on the role of IP in seeking VC funding. In the past few weeks, I have heard first hand about a VC pulling out of a deal because a medtech company got sued for patent infringement, another medtech startup received a letter of infringement and freaked out about what that means, another medtech company was granted a motion to dismiss a patent lawsuit, not to mention current and prospective clients wanting to file IP. My take on IP in medtech is that it is critically important and can get really expensive. The best way for startups to build an effective and robust patent portfolio is to first delay public disclosures for as long as possible to extend the clock to file (hence delaying spend), pursuing omnibus patent applications (to reduce the cost per invention), being strategic about what features to protect, being aware of each jurisdiction’s requirements around patenting, and being strategic around conducting landscape assessments to identify patent threats from competitors.

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Some VC investors believe that brick and mortar - referring to a physical presence of some kind - should be avoided at all costs. Yet, the track record of clinic and hybrid care businesses in health care indicates otherwise. ==> One Medical (sold for $3.9 billion to Amazon), Oak Street (bought by CVS for $10.6 billion), Lifestance (IPO at $7.5 billion market cap), and PE-backed Premise Health (acquired by OMERS Private Equity for $1.1 billion) If a clinic is indicated as the optimal way to deliver care for that patient population, there are creative ways to build and operate them. Full article below with advice and strategies on how to build and operate hybrid clinics from my teammate Anarghya Vardhana from Maveron, Amir Dan Rubin from OneMedical Group, Steven Eidelman from Modern Animal and more!

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In the latest episode of the NextGen VC #podcast we chat with Jeff Chu, founder and managing partner of Features Capital, an early-stage #medtech venture capital firm. Tune in to the full episode below!

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Had a blast diving into Amir Dan Rubin's extensive healthcare career on Vital Signs. Amir previously served as the CEO of One Medical and Stanford Health Care, was an EVP at United/Optum and is now the Founding Managing Partner at Healthier Capital. Our conversation spanned payer-provider integrations, lessons learned from leading One Medical, applications of generative AI, and more. Some highlights: ⚡Combining care models We talked a lot about the One Medical/Iora combination. Amir argues that just because two care delivery approaches may occupy the same physical location (e.g., a clinic), that doesn’t mean they necessarily need to conform to the same economic model. For instance, One Medical and Iora were able to combine effectively despite the former being a membership model and the latter being global capitation. Amir emphasizes that much of the overhead resources (e.g., front desk staff, phlebotomy) can be shared across models. ⚡How One Medical uses generative AI to improve efficiency One Medical allows members to message the care team, and then uses NLP to read the message, figure out its content, and triage it to the appropriate team member. Amir is excited about leveraging internal knowledge graphs to get around hallucinations. This approach can point to relevant internal data in helping compose responses, creating more trust and accuracy in the outputs. ⚡Behind the Amazon acquisition One Medical was interested in expanding its direct to consumer offering. However, they recognized that customer acquisition was costly, which is why partnering with Amazon Prime’s existing membership base made sense for them. Amir explains how at their core, both Amazon and One Medical are all about using technology and logistics to create an excellent customer experience. An awesome conversation ranging from health system innovation to startup strategy to health tech investing! Listen to our full episode below: Spotify: https://spoti.fi/3Wrbnol Apple: https://apple.co/3XWOomb

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🔋 #TodayinVC - All of the biggest deal announcements in venture capital - October 9th, 2024. Sourced from Litquidity NAOA's Exec Sum. · Maven Clinic, a virtual clinic for women's and family health, raised a $125M Series F led by StepStone Group · GROPYUS, a startup that prefabricates buildings using robots, raised a $109M round led by Semapa and Practical Venture Capital · Auger.AI, an AI-powered tool for supply chain-dependent businesses, raised a $100M seed round led by Oak HC/FT  · Resolve AI, an AI startup for engineers to automate software operations, raised a $35M seed round led by Greylock · AI testing platform Distributional raised a $19M Series A led by Two Sigma Ventures · MarqVision (YC S21), an AI-driven IP protection startup, raised a $16M Series A+ from Altos Ventures, QuantumLight, and more · VESSL AI, an MLOps platform to reduce GPU costs, raised a $12M Series A from A Ventures Group and more · Claim, a social app for Gen Z to discover brands, raised a $12M Series A led by VMG Partners  · Lightdash, an open source BI platform, raised an $11M Series A led by Accel  · Bitlayer, a Bitcoin Layer 2-based startup, raised a $9M Series A extension co-led by Polychain Capital and Franklin Templeton Venture Capital  · Driver, an AI helping firms create technical documentation, raised an $8M seed round led by GV (Google Ventures)  · Third Dimension AI, a 3D GenAI startup, raised a $7M seed round led by Felicis  · Data management platform Kiva AI raised a $7M seed round led by CoinFund  · Edtech Revyze raised a $6M seed round led by Speedinvest and Moonfire Congrats to all teams! Follow for daily #venturecapital news! 📆

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Thrilled to announce our investment in Counsel Health, the world's first medical service that provides unlimited, near-instant access to the world's best doctors! Counsel is democratizing access to high quality, tailored medicine via a text-based care model delivered by AI-enabled physicians. When patients message a question, Counsel's in-house clinicians respond quickly and at any time with hyper-personalized and up-to-date medical advice - incorporating all past conversations, medical history, patient preferences and latest medical guidelines. In the past, we have seen the important impacts of care setting shifts ranging from emergency medicine to telehealth as well as that of leveraging new technologies from SaaS to AI. Counsel’s vision incorporates all of the above and more: delivering care via the next setting frontier where it's most accessible for patients (phone-based messaging) and applying the latest AI techniques and LLM advances to enable faster, more personalized and up to date care. It’s doing this while being physician-first, with a high quality, high empathy doctor in the loop. It's been a joy and privilege to back Muthu Alagappan, MD, Rishi Khakhkhar, MD, MBA, Justin Yu and the rest of the Counsel Health team. We at Asymmetric are excited to be joined by our friends at Andreessen Horowitz (Julie Yoo, Jay Rughani), Floodgate (Ann Miura-Ko), Pear VC (Vivien Ho) and Founders You Should Know (Jennifer Yip). Rob Biederman Sam Clayman Matty Mejia-Johnston Sarah Unger Biggs Michele Spitzer https://lnkd.in/dyP5xCRx

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I was having a chat with my colleagues the other day about our portfolio (we've got a pretty diverse founder group - it's something we actively monitor and are proud of) and general founder dermographics across VC backed companies. One big discussion point that came about - entirely organically with 'tech bros' as an inspiration - was regarding the age of founders across our portfolio (again, we have a great mix) and more generally across lifesciences/healthcare and tech and whether there was a difference in how well they were performing and their success. So.....me being me....I thought i'd do a bit of reading. As an FYI, this topic came up several year ago pre-COVID (I recall a Wharton report as particularly stand-out-ish) and from memory, the general consensus was that 35 - 45 year olds tended to 'perform' better as entrepreneurs. Has it changed over recent times, especially given the COVID driven digital switch? Here's a snippet of what I found (there are unsurprisingly quite a lot of articles...): 👉 A comprehensive study from FounderJar found that a 40-year-old founder is 2.1 times more likely to succeed than a 25-year-old, with the average age of successful founders at 41.5 years. Even more impressive, the average age of those who exit with an IPO or acquisition is 46.5. You can check out the full article here: https://lnkd.in/eGc_3MRB 👉 Business Initiative reports that 50-year-old entrepreneurs are nearly twice as likely to succeed compared to 30-year-olds, apparently due to their experience, financial stability, and developed networks. More on this here: https://lnkd.in/eGawmZmi 👉 And finally, The article from The Conversation challenges the common belief that young people are the most radical innovators, revealing that individuals over 50 are often the more transformative entrepreneurs. The research highlighted in the article indicates that older entrepreneurs possess greater experience, industry knowledge, and networks, which allow them to take a more innovative approach to problem-solving. Link: https://lnkd.in/erjpWRWD Thoughts welcome... #Entrepreneurship #StartupSuccess #ExperienceMatters #AgeIsJustANumber #EarlyStageInvesting

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Abby Levy talks about venture's role in US healthcare and what we can expect to see as technology impacts the space on TFR. Check out the rest of the conversation with Abby & Alan Patricof of Primetime Partners on Episode 433.

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The most talked about AI x Medical startup Abridge is working to rescue doctors from the never-ending admin grind (which causes burnout and less patient face-time). Abridge's AI listens to patient visits and generates precise medical notes, slashing the clerical workload. Now, doctors can focus on what truly matters: patient care. Major health systems like Yale and Emory are already on board and raving, calling it "life-changing" and "magical." 🔷 A big reason --> Payback of the scribe tool is easy to measure. It supports 14 languages including Haitian Creole, Brazilian Portuguese, and Punjabi. An ongoing criticism of generative AI is that it still has few substantive business applications. This seems to quash that. Question: is a dedicated medical LLM needed to be successful in the space? Or will the huge foundational models (GPT-4o, Google, and Meta) ingest a plethora of medical notes and kill the competition with performance? We're dealing with a fast and furious pace, and today's edge may not be relevant tomorrow. Competitors include Microsoft-owned Nuance Healthcare , Ambience Healthcare, Nabla and Suki. I'm excited to continue to see this field revolutionized. 🌟 #AI #MedTech #Abridge #HealthTech

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#hiring If anyone knows an awesome engineer that would be interested in joining an emerging #AI company doing important work in #healthcare, please drop me a line! Andy AI is backed by General Catalyst, YCombinator, Greater Ventures, and others, and they’re looking to hire a full stack engineer (US based) who's excited about using AI to improve healthcare and reduce nurse burnout. Andy is AI software that automates clinical documentation for nurses who do home visits. A nurse makes an audio recording of the visit and Andy automatically generates a form that usually takes nurses 90 minutes to complete. Nurses love the product because it potentially saves them 15 hours of charting a week! The founders previously built healthcare AI at Google Health and Apple, and are now building their vision to transform home health. More about Andy AI: https://with-andy.com/ Nurses love it: https://lnkd.in/g9XqZrUq #GenAI #digitalhealth #hiring #engineers #healthtech

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When I was a pre-partner at a VC firm, my job would be to review board decks with a founder ahead of the partners’ review. The function was usually top-notch, because our founders were amazing, but I would *obsess* over form, which, in retrospect, was a complete waste of time for everyone, especially the founder (lookin’ at you, Nicholas Vandivere – sorry I was so annoying 😬). Today, as a founder myself, I’ve completely thrown form out the window. If you’ve raised a few million dollars, are generally profitable, and are chugging along as a seven-figure business like Rescripted is, you should be having regular, informal update calls with members of your board and reporting to your investors at least quarterly (VCs require this, of course, but if you’re angel-funded like we are, you might not know the nuts and bolts!). Board meetings aren’t for reporting. That’s why form doesn’t matter. You should *constantly* be reporting. If you have a great and supportive board like we do, board meetings are for: 👩‍🏫 interpreting the reporting you've already done, 📣 providing commentary that isn’t obvious, 🤗 providing feedback to yourselves as a management team, 💫 and getting advice and insights from those people who believed in you enough to put their money where their mouths are. Tomorrow’s our board meeting. Wish Kristyn Hodgdon, Peregrin Marshall, and me luck! If you’re a founder, how do you run effective board meetings? #entrepreneurship #seedinvesting #angelfunding

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Wilson Sonsini Goodrich & Rosati's Rebecca DeGraw on the common legal pitfalls that could delay your funding and how to avoid them as you grow. As startups scale, converting notes and securing a priced round often becomes a key consideration. That's why getting your cap table, IP, and employment agreements in order is a must for closing the deal.

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Should you sell your practice to a VC-Backed MSO Startup? tldr: - new VC-backed startups are forming MSOs to roll up independent practices - The pitch is physicians receive early liquidity from the roll up and are granted ESOP shares that can be used for retirement - Problem is the use of ESOPs with independent practices is not a new concept and has been used with large group practices since the 70's - ESOPs do not grant full ownership and in order for the shares to be valuable for retirement, the practice needs to run the same if not better post roll up - With VC-backed startups being primarily operated by non-physicians with zero clinical or medical practice experience, the likelihood of this happening is extremely low making the entire concept high risk However, there is a viable path for continued ownership + liquidity for independent practices. Check out the article to learn more. ⤵ https://lnkd.in/gmGvTYwP

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At the annual Decoding Bio summit, I sat down with Brad Loncar of BiotechTV to discuss how we at Bessemer Venture Partners are thinking about where value accrues for AI in biotech. The short answer: Ultimate value accrues at the therapeutic level. Longer answer: If AI improves drug discovery along any axis (speed, efficiency, cost, new biology, novel chemistry), and becomes a near-ubiquitous tool in the discovery process, value will accrue up the stack. Vertical integration of discovery and development will be essential to capture this value, and the greatest moats will (still) be built in clinical development – trial design, biomarker identification, indication selection, and raw execution.

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To my amazing network - I am thrilled to announce the launch of Pave Health Ventures, an early-stage venture fund dedicated to broadening access to healthcare and improving the overall well-being of our communities. I’ve been very fortunate in my healthcare career. As the Founder & CEO of MedPilot, we capped off a seven-year journey with a successful exit when we were acquired by Vytalize Health. For the last three years, serving as Chief Innovation Officer, I’ve had the honor to contribute to the remarkable growth at Vytalize, impacting the lives of hundreds of thousands of patients by enhancing the quality of care they receive. I am immensely grateful to Matt Buder Shapiro, not only for being the perfect partner and co-founder but also for being an incredible friend. Additionally, I extend my heartfelt appreciation to Faris Ghawi, Amer Alnajar, and Jordan Brown for their outstanding leadership and for broadening my perspective on the significance of value-based care. This journey has not only provided me with industry expertise but has allowed me to cultivate invaluable relationships and an incredible network. As I embark on this new chapter, I am profoundly grateful to be supported by top executives and thought leaders in the investment, wellness, and healthcare industries. Within the healthcare ecosystem, we are represented by key stakeholders from health systems, insurers, governmental organizations, retail health businesses, provider groups, and value-based care organizations. At Pave Health Ventures, we believe the timing couldn't be more opportune to help support health-focused startups. With the growing prevalence of illness and chronic health conditions impacting our communities, consumers and key Healthcare Stakeholders are increasingly prioritizing proactive and preventative care. This shift in focus is fueling demand for technology, products, and services aimed at improving health outcomes, unlocking trillions of dollars in growth potential within the healthcare landscape. Pave Health Ventures is all-in. We are actively seeking solutions that tackle the root causes of illness, manage chronic conditions, and optimize care and care teams. Please support us in our mission by opening your networks and introducing us to amazing founders and entrepreneurs. Together, let's help pave the way to a healthier tomorrow. Jacob Myers

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I’m a lucky man - I get to talk about stuff I care about with people that feel the same way, but know how to approach it in fresh ways. This chat with Josh Au Yeung goes into another area I think needs much more attention - leadership. NHS providers recently published data showing only around a third of NHS CEOs have a clinical background: https://lnkd.in/givrbU_p . When evidence suggests that expert leadership is strongly associated with better outcomes, happier staff, and greater productivity, we need to work harder to identify, train, and support current and future clinical leaders. The burning question is this: when it comes to #HealthTech , who is the expert leader? A technologist? A clinician? A hybrid? Would love to hear your thoughts on this (and the podcast, naturally)

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A little late, even though this process started in July.... Excited to share our latest investment in Heads Together Health!! We met Steve DeVrieze in October last year, and we think they are poised for impressive growth! Read more here: https://lnkd.in/ecYcqqkn #earlystagestartup #earlystageinvesting #VCinvestment #ncstartups #nctechstartups

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