Sam Ajizian, MD, Medtronic Chief Medical Officer, Patient Monitoring

Patient Engagement

Florence Debuts With $20M to Unlock Capacity

Patient experience startup Florence emerged from stealth with $20M in seed funding to address what it views as the most significant constraint in care delivery: clinical capacity.

Backed by venture teams from Google, Salesforce, and Thrive Capital, Florence is developing solutions to help patients track and accelerate their care journeys using their smartphones.

The first stop for Florence, as with a growing number of patients, is the emergency department. 

• Using Florence’s mobile platform, patients in the ED can complete intake forms, update clinical information, initiate self-discharge, and schedule follow-ups.

• The mobile-first self service solution is designed to eliminate operational overhead while cutting down on ED wait times and patients leaving before seeing a provider. 

• The entire system is integrated into existing workflows to deliver an experience that rivals what consumers are used to in other industries. The idea is that patients get real-time updates, providers get better ED throughput, and everyone goes home happy.

Florence’s strategy leads with product, and the seed funding will be used to hire design and engineering talent to help advance that goal.

• The “optimize capacity, streamline admin” value proposition is reaching providers at the right time. Since kicking off operations in 2021, Florence has added 40 health systems to its client roster, including its marquee partnership with Maryland-based Luminis Health.

• “Non-clinical workflow” companies began topping Rock Health’s digital health funding charts back in Q3 2022, and between Florence, Vital, and LeanTaas’ activity within just the last week, that trend looks like it’s here to stay.

The Takeaway

Florence plays at the intersection of healthcare consumerization and workflow optimization, two themes that were definitely standouts at ViVE Nashville last week. If Florence can keep drawing a straight line between its solution and higher provider revenues, it should have no problem finding more health systems looking to streamline their EDs.

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The Wire

• Hint All-in-One: Hint Health released its new Hint All-in-One platform purpose-built for direct primary care clinics. All-in-One pulls together Hint’s core membership management and billing solution with a clinical application that’s equal parts EMR, practice management app, and patient communication solution. Hat tip to Hint for putting out such a complete product within the 6-month target deadline it set for itself after acquiring AeroDPC late last year.

• Retail Clinic Utilization Up 51%: The Sixth Annual FAIR Health Report attracted a lot of attention for its headline stat – telehealth use fell 76% from 2020 to 2021 – but some of the retail healthcare numbers were even more surprising at first glance. Retail clinic utilization spiked 51% over the same one year period, and has more than doubled since 2016. Although the momentum of players like CVS, Walmart, and Walgreens is certainly playing a role here, it’s hard to judge the extent of the impact given physician office closures during the study period, and it’ll be interesting to see if the trend persists in this year’s data.

• Wellvana Secures $84M: Wellvana secured $84M (total funding now $140M) to help PCPs, specialists, and health systems transition away from FFS with “a differentiated value-based care approach that only succeeds when two things align: data-driven technology and high-touch human engagement.” The startup currently serves over 100k lives through commercial payors, Medicare Advantage, and ACO REACH, with much of its growth arriving last year following its merger with VBC enablement platform Prime Holdings.

• Preventative Screening Coverage Overruled: A Texas federal judge struck down an Affordable Care Act mandate requiring health plans to fully cover preventative services such as cancer, HIV, and diabetes screening exams. The ruling stated that the task force that initially recommended the coverage was unconstitutional because its members were neither appointed by the president nor confirmed by the Senate. The ruling takes effect immediately, but the HHS has already appealed the decision, and it looks like the Supreme Court will soon have another chance to direct the future of the ACA.

• Telehealth Plus OUD Treatment Results: Combining telehealth with opioid use disorder treatment led to a 33% lower likelihood of fatal overdose in a large joint study from the CDC, CMS, and NIH. Researchers compared the outcomes of over 175k Medicare beneficiaries before and during pandemic regulatory flexibilities, finding that only 1 in 5 beneficiaries used telehealth, and only 1 in 8 received medication treatment despite the PHE allowing telehealth prescribing of buprenorphine. The authors call for a continuation “of our efforts to broaden the use of telehealth” for OUD treatment as PHE flexibilities are rolled back.

• Inato’s Inclusive Clinical Trials: Clinical trial startup Inato closed $20M in Series A2 funding to enable trial sponsors to meet newly imposed FDA diversity requirements. Inato is looking to flip the standard clinical trial model on its head with a platform that lets pharma companies post information about upcoming trials so that potential sites can view the requirements and submit an enrollment plan if interested. Inato reviews and verifies the applications, then provides the trial sponsors with recommendations. 

• Fiery Resignation From Cano Health: Barry Sternlicht resigned from the board of Cano Health after leading the SPAC that took the company public. Sternlicht wasn’t shy about burning bridges on his way out, saying in a public resignation letter that he felt “extremely troubled by the poor operating decisions… and by the inability to forecast the Company’s financial performance.” Cano shares took a 20% beating following the departure, and considering Sternlicht personally owns close to a tenth of the company, frustrations were clearly running hot enough that he felt the need to put out the letter regardless of any damage to his own stake. 

• Pullback on Prior Auth: UnitedHealthcare plans to reduce its number of procedures requiring prior authorization by 20%, starting this summer. The company said that while prior authorization can “ensure member safety” and lower medical costs, it is a “pain point” for providers – sentiment that aligns with a recent AMA study finding that prior auths lead to delays in care. United notably added that it will also start a “gold card” program to eliminate prior auth requirements for some providers.

• Deloitte 2023 Health Outlook: Deloitte recently put out its Updated 2023 Global Health Care Outlook, which included five strategies to help counter the shortage of 80M providers it expects by 2030. It’s a robust report, but the juice is worth the squeeze if you’re in the mood for a deep dive on: 1) increasing flexibility, 2) overhauling credentialing requirements, 3) streamlining documentation, 4) remote patient monitoring, 5) health worker benefits.

• FDA Med Device and AI Changes: The FDA published draft guidance on how it will regulate updates to AI/ML algorithms in response to new data. The guidance is designed to promote innovation by allowing AI/ML medical devices to more easily learn from local conditions (e.g. diagnostic devices could be built to adapt to the data of individual facilities). In other regulatory news, Section 3305 of the Omnibus is in effect as of last week, meaning that companies can’t market medical devices without first showing the FDA a solid cybersecurity plan.

• RhythmScience Funding: Cardiology data analytics company RhythmScience landed a $6M Series A investment led by Cedars-Sinai Health Ventures that it will use to further develop its Rhythm360 platform. The cloud and AI-based Rhythm360 platform is already active at several major health systems, and is used to analyze and monitor cardiology patients’ device data (implants, wearables, PB cuffs, weight scales) to reduce missed diagnoses and avoid unnecessary hospitalizations.

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