ViVE 2024 Recap and Major Announcements

ViVE Los Angeles is officially a wrap, and the collaborative event between HLTH and CHIME keeps growing up right before our eyes.

The show’s third year eased up on the flashy displays and DJs that were hard to miss in Miami and Nashville in favor of a more down-to-business approach, not unlike the AI conversations happening in the expo hall.

True to form, the vendors were the stars of the show, so we’ll follow ViVE’s lead and get right into some of the biggest announcements that came out of La La Land:

  • Arcadia unveiled its next-generation data platform powered by an open lakehouse architecture. We won’t pretend to know exactly what that means, but it’ll apparently be a nice boost to Arcadia’s population health and value-based care capabilities.
  • Artera gave an update on its digital health marketplace, which now includes 50+ vendors after bringing on newcomers like Azara Healthcare, Health iPASS, and Memora Health. Artera’s Message API now receives a whopping 150 million calls each year.
  • AvaSure rolled out its Episodic virtual care solution that allows care teams to seamlessly collaborate regardless of location around admissions, discharges, rounds, and specialty consults.
  • Biofourmis is partnering with GE HealthCare to enhance continuity of care during transitions from the hospital to the home. Biofourmis’ care-at-home solutions will extend GE HealthCare’s inpatient monitoring portfolio.
  • Brightside Health announced a string of new payor partnerships to support Medicaid and Medicare after moving into the space a few months ago. The big name roster includes CareOregon, Blue Shield of California, BCBS of Texas, and Centene.
  • CancerX revealed the 16 members of its inaugural Startup Accelerator, which includes a healthy mix of up-and-comers across clinical research, diagnosis, treatment, operations, and care experience. 
  • DeepScribe is working with Amazon Web Services to scale purpose-built healthcare LLMs, and is incorporating AWS HealthScribe into its platform while also making its ambient documentation tool available to health systems through AWS Marketplace.
  • Elevance is launching a digital weight management program for employer clients of its CarelonRx PBM. Users who are prescribed GLP-1s will have access to medication management support and a digital companion module.
  • Gozio released new data showing that 86% of patients who received medical care in the last year used a mobile device when interacting with their provider. Although using a single platform to reach their provider is important to nearly all patients, 46% are still using multiple.
  • Highmark is joining forces with Epic and Google to bring more data to the point of care. Epic’s Payer Platform will enable “bidirectional” data sharing between the payor and providers, while Google Cloud will allow the tech to integrate with Highmark’s existing systems.
  • Included Health is embedding the CDC’s Healthy Days measure into its navigation service following a successful two year pilot.
  • Vale Health made its grand debut as it looks to build an online marketplace of vetted wellness offerings for consumers, and it already has sixteen health systems in its corner.
  • Veda Health is teaming up with Humana to improve the accuracy of its provider directories and ensure that seniors have real-time details about in-network providers. Love to see this come full circle after Veda got its start in a Humana hackathon back in 2016.
  • Xealth’s Digital Health Review showed how digital tools are reshaping surgery, chronic care, and preventive services. Preventive care programs are seeing the highest levels of patient engagement, while surgery preparation programs see the highest enrollment.

Huge thanks to all of our readers who were in LA and took the time to walk us through the latest and greatest. For everyone holding onto more announcements for HIMSS, we’d love to connect in Orlando. Hit reply and let’s get it on the books!

DarioHealth Acquires Digital Therapeutics Startup Twill

The flash flood of ViVE news is officially here, and one of the biggest stories from the first wave was DarioHealth’s acquisition of mental health digital therapeutics startup Twill for $10M plus another $20M in stock.

Dario got its start in 2011 with a direct-to-consumer diabetes app before expanding to cardiometabolic, musculoskeletal, and behavioral conditions. Although Dario still operates its D2C business, it’s since shifted its primary market to employers and health plans to reach larger patient populations.

  • Dario hasn’t shied away from fueling its expansion through M&A, most recently acquiring a trio of companies in 2021 that included wayForward (behavioral health), Upright (MSK), and Physimax Technologies (also MSK).
  • Despite the momentum, Dario hasn’t notched a profitable year since going public in 2016, and it’s looking to Twill to help expedite that journey.

Twill provides configurable Sequences that combine its digital therapeutics with partner solutions to address specific clinical needs such as mental health (Happify) and pregnancy (Elevance).

  • These Sequences are used by three of the five largest US health plans, over half of the top 20 global pharmaceutical companies, and reportedly cover 18 million lives.
  • Twill raised $153M through 2021, so while some quick napkin math probably suggests this wasn’t exactly a glowing exit for investors, the stock-based transaction at least means that there’s some upside if the combined company succeeds.

Outside of the immediate scale achieved through Twill’s customer-base, Dario is banking on its newly consolidated offering striking a chord with employers that are grappling with point solution fatigue and workers in need of mental health support.

  • During Dario’s last investor call, it said that it expects to reach breakeven at ~$80M in revenue (about 4x what it currently generates in a year), but Twill should help in this department.
  • Since Twill and Dario share minimal customer overlap, joining forces should allow them to cross promote their services, and Dario expects the acquisition to double its revenue this year as a result.

The Takeaway

At a time when the market is demanding more value from fewer vendors, Dario’s acquisition of Twill is promising to deliver just that. All eyes will be on the integration of Twill’s platform to see if the expected revenue gains will be realized, but Dario has a track record of successfully folding in acquired companies, so this could end up being one of the first dominoes to fall in a long-awaited chain of consolidation.

Oula Lands $28M for Modern Maternity Care

Topping off a week packed with women’s health stories was maternity care startup Oula’s close of $28M in Series B funding.

Oula’s modern maternity centers combine obstetrics with midwifery to ensure expectant mothers receive comprehensive support throughout their reproductive journeys. 

The philosophy behind Oula is that most pregnancy care takes place between visits, so offering in-home support, better education, and virtual access to providers should create a virtuous cycle for improving outcomes.

  • Oula also places a heavy emphasis on inclusive care by working with most major payors and Medicaid, as well as its dedicated support for BIPOC parents and families.  
  • By finding a middle ground between hypermedicalized and non-medical care, Oula’s pair of New York Clinics have delivered a 26% better C-section rate, a 61% lower preterm birth rate, and a 50% better low birth weight rate compared to the city’s benchmarks. 

The funding arrives as maternal deaths continue to climb in the US, which leads all other high income countries with 23.8 deaths per 100k births (and an abysmal 55.3 deaths per 100k births for Black women).

  • A large part of these discrepancies appears to be due to a lack of access to midwives, certified medical practitioners with expertise in low-risk pregnancies, which also see far worse reimbursement than physicians.
  • Oula makes the case that the US’ lack of proper reimbursement mechanisms for midwives is a key driver of its poor outcomes, and tackling that issue is a core component of its mission.

The Series B will help Oula round out its platform with services like preconception coaching and enhanced miscarriage support, while also allowing it to scale to more markets to rival established players such as Maven Clinic and Progeny Health.

The Takeaway

Oula is looking to modernize maternity care not only by wrapping a tech-enabled bubble around traditional obstetrics, but also by catering to the specific needs of the mothers and health plans that it serves. It’ll have its work cut out for it scaling from a few New York clinics to a nationwide platform, but it’s hard to ask for better timing or a greater need.

The Case For More Retailers and Health Systems to Partner

A new viewpoint in the Harvard Business Review made the case that health systems and retailers are only scratching the surface of their partnership potential.

The authors – a trio of professors out of Harvard and UNC – outline four actions they believe health systems and retailers should take to better coordinate their complementary services.

Move Beyond Convenience. Retailers like CVS and Walmart are beginning to add services such as primary care, mental health counseling, and home care, yet even more robust solutions like Amazon Clinic still fall short of integrated care. 

  • Things like cancer treatments and surgeries remain well outside the realm of retail health, yet a close partnership between a retailer and a health system could help integrate the many elements involved in treating more-serious conditions.

Move Care Into the Home. Although retail clinics are more convenient and accessible than hospitals, patient homes have them beat on both metrics. Hospitals have begun offering more care in the home, but often lack the logistical prowess to supply patients with the monitoring tech needed for larger programs.

  • Efficiently equipping patients’ homes with RPM devices is right in the retailer wheelhouse, and a partnership could fill the gap. Look no further than Best Buy and Geisinger for proof.

Leverage Data to Improve Care. The data held by retailers and health systems largely remains in separate databases, with some notable exceptions like Target-Kaiser Permanente.

  • The authors point out that better integration could help with everything from flu outbreak prediction (grocery carts filled with tissues = sick people) to food-as-medicine programs (well-timed nudges and incentives).

Change Who Delivers Care. Labor shortages are one of healthcare’s biggest immediate obstacles, and few employers have a larger workforce than retailers. The article gives the example of Walmart, which subsidizes education for its employees to train for roles like pharmacy technician and medical assistant.

  • Health systems could ensure these training programs meet quality standards and help graduates find jobs, creating a model where retailers attract more ambitious candidates and providers have a new talent pool to tap into.

The Takeaway

One way or the other, retailers are moving past the Retail Care 1.0 era, and it’s hard to argue against the case for tighter retailer-provider partnerships. Even if consumers might not jump at the idea of sharing their grocery list with their physician, the ideas outlined in this article are good food-for-thought for combining the complementary strengths of retailers and providers to improve the system as a whole.

Ambience Healthcare Locks In $70M for AI Operating System

Ambience Healthcare just closed $70M in Series B funding to cut away at burnout-inducing manual workflows using the latest advances in generative AI.

Ambience’s carving knife isn’t an AI scribe, a coding solution, or a referral tool, but an “AI operating system” that promises to be all those things at once.

That operating system consists of a holistic suite of genAI applications catering to an impressively broad set of use cases. Each app is customized for dozens of specific specialties, care models, and reimbursement frameworks:

  • AutoScribe: AI medical scribe that works across all specialties
  • AutoRefer: AI referral letter support for both PCPs and specialists
  • AutoAVS: After-visit summary tool that generates custom educational content
  • AutoCDI: Point-of-care clinical documentation integrity assistant that analyzes notes and EHR context to ensure ICD-10 codes, CPT codes, and documentation are aligned

Ambience has kept tight-lipped about both its customer count and LLM provider, but we do know that it as:

  • $100M in total funding since launching in 2020
  • Marquee customers like UCSF, Memorial Hermann, and John Muir Health
  • Investments from Silicon Valley heavyweights like Kleiner Perkins, a16z, and OpenAI (probably a decent hint toward the unrevealed LLM partner)

The newly-raised capital will accelerate Ambience’s product roadmap and allow it to build dedicated support teams for its health system partners.

  • The first product up on that roadmap is AutoPrep, an intelligent pre-charting solution that equips clinicians with suggestions for the visit agenda and potential conditions to screen for.

Ambience’s operating system strategy not only gives it a huge total addressable market, but also positions it apart from well-established competition like Nuance and Augmedix, as well as a hungry pack of genAI up-and-comers such as Nabla and Abridge.

  • A continuously learning OS with “a single shared brain” sounds like a versatile way to break down silos, but the flip side of that coin is that providers looking for an answer to a specific problem might be tempted to go with a more specialized solution.

The Takeaway

Driving adoption of any software is hard. Crafting a beautiful user experience is hard. Tailoring a continuously learning AI operating system to every medical specialty sounds extremely hard. At the end of the day, Ambience’s approach is about as ambitious as it gets, but it carries massive advantages if it can execute.

Fabric Acquires Conversational AI Startup Gyant

It was another action-packed week in what’s shaping up to be a busy 2024, with healthcare operations enabler Fabric acquiring conversational AI assistant Gyant.

If the name Fabric doesn’t ring a bell, that’s because the acquisition announcement was also the grand debut of Florence’s rebranding to the new moniker.

Florence – now Fabric – launched last March with $20M in seed funding to address what it views as the most significant constraint in care delivery: clinical capacity.

  • The first stop for Fabric, as with a growing number of patients, was the ED. Using Fabric’s mobile platform, patients in the ED can complete intake forms, update clinical information, initiate self-discharge, and schedule follow-ups.
  • The idea is that patients get real-time updates, providers get better ED throughput, and everyone goes home happy.

Fabric then went on to pick up Zipnosis off of Bright Health less than two months after closing its seed round, broadening its product suite with asynchronous telehealth and accelerating its roadmap to new sites of care – particularly the home.

  • The cherry on top of the acquisition was that Zipnosis also brought along 50+ health system customers, giving Fabric a foot in the door to start offering its other services.

Enter Gyant, which fits right into Fabric’s clinical capacity strategy by providing a conversational AI assistant that “empowers patients to self-navigate, connecting to them wherever they prefer to engage.”

  • Fabric had an existing integration with Gyant that allowed patients using the symptom checker within Gyant’s assistant to initiate telehealth visits powered by Fabric (courtesy of Zipnosis). 
  • Just to call a DFD a DFD, Gyant basically helps serve as Fabric’s digital front door.

Fabric’s “optimize capacity, streamline admin” value proposition is reaching provider ears at the right time. Since kicking off operations not too long ago, Fabric’s added 70 health systems to its client roster, and has apparently climbed from zero to eight-figures in ARR.

The Takeaway

Through its acquisition of Zipnosis last year, the company then known as Florence made it clear that it was looking to become an end-to-end healthcare operations enablement platform through any path necessary, including M&A. Now with the addition of Gyant, Fabric is walking the talk.

How Health Systems Are Approaching AI

The New England Journal of Medicine’s just-released NEJM AI publication is off to the races, with its February issue including a stellar breakdown of how academic medical centers are managing the influx of predictive models and AI tools.

Researchers identified three governance phenotypes for managing the AI deluge:

  • Well-Defined Governance – health systems have explicit, comprehensive procedures for the evaluation of AI and predictive models.
  • Emerging Governance – systems are in the process of adapting previously established approaches for things like EHRs to govern AI.
  • Interpersonal Governance – a small team or single person is tasked with making decisions about model implementation without consistent evaluation requirements. 

Regardless of the phenotype, interviews with AI leadership at 13 academic medical centers revealed that chaotic implementations are hard to avoid, partly due to external factors like vague regulatory standards.

  • Most AI decision makers were aware of how the FDA regulates software, but believed those rules were “broad and loose,” and many thought they only applied to EHRs and third party vendors rather than health systems.

AI governance teams report better adherence to new solutions that prioritize limiting clicks for providers when they’re implemented. Effective governance of prediction models requires a broader approach, yet streamlining workflows is still a primary consideration for most implementations. That’s leading to trouble down the road considering predictive models’ impact on patient care, health equity, and quality care.

The Takeaway

Even well-equipped academic medical centers are struggling to effectively identify and mitigate the countless potential pitfalls that come along with predictive AI implementation. Existing AI governance structures within healthcare orgs all seem to be in need of additional guidance, and more guardrails from both the industry and regulators might help turn AI ambitions into AI-improved outcomes.

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