1. brentgrinna:

    image

    There has been a lot of commentary recently stating that MBAs, and Harvard MBAs specifically, aren’t very good startup founders.

    Only 12 of the 39 companies had any MBAs within their co-founding teams…only three had at least one co-founder who went to HBS.” – Dan Primack of Fortune

    “I would bet a large amount of money that the overwhelming majority of us would not look favorably on a company started by one of you” - Chamath Palihapitiya on Harvard MBAs

    Yes! Fantastic data… and while VC fundraising isn’t necessarily a sign of business success, given the status of several of these companies growth and revenue wise, odds are there will be at least a few good outcomes in this batch. And kudos to b-schools for adapting their teaching and curriculum in recent years to promote more “non-traditional” MBA careers such as technology and entrepreneurship.

    -cch

     
  2. 12:44 7th Feb 2014

    Notes: 45

    Reblogged from oscarhealth

    Tags: healthcarehealthinnovation

    image: Download

    naveen:

What I’ve been doing at Oscar.
These past few months, I have been helping a couple of startups I like.
Sometimes, I have been investing in them. (Well, I’m trying to: I am basically making it up and learning as I go along, but it could be argued that’s what all angel investing really is about.)
Sometimes, I have been spending time hanging out at a company and helping more directly.
But regardless of whether I invest or help a team more directly, I think the way I’ve been thinking about it is to only get involved in projects that I wish I myself had started. (Max Levchin said it best: “One of the best heuristics I found when deciding to invest [in] a startup is whether I would seriously consider joining it, if asked.”).
The company that I’ve spent the most time with recently is Oscar Health: I’ve been here for the last five months.
If you know me, you already know I’ve been curious about and playing around in the health space. My hacking around in the quantified self space brought me to personal health, which is basically the idea of using tools (either built by the community or by health & fitness companies) to take charge of our own health. This personal health movement can be thought of one model where care is proactive rather than reactive. All this got me closer to learning about where the healthcare system is really broken and needs technology’s help the most.
That, of course, brought me to Oscar. I had already known the guys before they got started and I was always excited about the possibilities anytime we got together to talk about the idea of starting an insurance company. If you want, think of my exploration as a see-saw: “things that we do for ourselves” on the left and “things a care provider does for us” on the right. I started on the left and I slowly started learning and moving right. And then I figured I should skip ahead and jump all the way to the right and see the world from Oscar’s perspective.
I’ve been helping Oscar in various roles: with recruiting for different parts of the team (mainly on the product and engineering sides); with general company “things” (helping with PR/marketing, with process, organizing engineering and recruiting meets, &c.).
I also spent a lot of time helping build different parts of the product:
The mobile experience - of course, this one was easy. Many of our members are young and tech-savvy and almost always on their mobile phones. They order food, their cabs, buy movie tickets, read the news, see train times, search for things exclusively on mobile. So why shouldn’t they have a great experience where their healthcare questions and delivery also happens on mobile? I made this a big priority for the team for the January 1st launch: we worked nights and days with a very tiny team. And, in something like eight weeks, we put together a great Oscar Member app for iOS. (Yes, Android at some point very soon!).
The care finder - this tool can be thought of as your first point of contact when you look to solve an issue in health for yourself or a family member. Instead of blindly Googling for an answer, we imagine that Oscar itself can be your first point of contact. You could even think of it like foursquare’s “Explore”: before you go somewhere, use the search and allow it to pass you to the right spot. The mechanics of how this works are hidden behind the scenes in order to keep the interface simple, but the idea is that it will use basic information about each provider to point you to the right place. Over time, we imagine this system can get better as more data points and views from your friends are added in. “Show me only doctors that can speak Spanish.” – “Go here because many people your age go here.” – “Show me only providers that have many years of experience and happen to be tech-savvy, too.” Why should a health insurance company only step in at the very end of care? (That is: at the point where care has already been delivered and the insurer only steps in to pay your bill for you.) The idea instead is that when you need help, you ask us and we point you to an appropriate place of care that not only solves your needs but also does it transparently.
The “Doctor on Call” - this one is something we are really proud of and excited about. Some of us were lucky enough to grow up with a family doctor who would be able to answer simple questions over the phone: helping you get care and saving you time from having to drive out to the doctor’s office and taking a couple of hours out of your work day. Whatever happened to those days? Oscar’s “Doctor on Call” does exactly this. We’ve partnered with Teladoc and their physician network to provide this service. So, at any time, no matter where you are (in the U.S.), you’ll be able to ring up a doctor and talk to them about a problem you have. The doctor will be able to recommend a solution, prescribe you medicine or, in cases where a further in-person visit is needed, send you to a specialist to get care. And the best part: all this is free for members. We could have pointed members to independent applications out there now that seem to do this, but we wanted to embed this experience natively into Oscar itself. This way, you never have to leave this ecosystem and use yet another login to use such a system. And by seamlessly integrating this, we could also hide the costs and make it free for you in a much easier way.
All-in-all, this is just the start of even deeper products and issues Oscar can solve.
The appeal in Oscar is not only that we get to see through 2014 eyes and solve all the things that incumbents have trouble solving. Or the fact that we can bring a tech-focused approach and solutions to the health care space. To me, the most exciting is that by starting over from scratch, we have the ability to write a new playbook on how a health insurance company should work. We have a chance to provide additional features and services that customers have not expected before. We have the ability to start your care and our relationship with you not after you get hurt and after you’ve been fixed up by the doctor, but rather by being the first point of contact when you do need care. And perhaps, someday, so easy we will even get one step ahead of you and actively alert you to offer you services before you come to realize you need them.

Building a health insurance company anew from the ground up for the 21st century is a huge undertaking. But one that has consumers and technology (web and mobile) as part of its core value proposition and product strategy  is refreshing. The way it should be, as it is done in most other industries. -cch

    naveen:

    What I’ve been doing at Oscar.

    These past few months, I have been helping a couple of startups I like.

    Sometimes, I have been investing in them. (Well, I’m trying to: I am basically making it up and learning as I go along, but it could be argued that’s what all angel investing really is about.)

    Sometimes, I have been spending time hanging out at a company and helping more directly.

    But regardless of whether I invest or help a team more directly, I think the way I’ve been thinking about it is to only get involved in projects that I wish I myself had started. (Max Levchin said it best: “One of the best heuristics I found when deciding to invest [in] a startup is whether I would seriously consider joining it, if asked.”).

    The company that I’ve spent the most time with recently is Oscar Health: I’ve been here for the last five months.

    If you know me, you already know I’ve been curious about and playing around in the health space. My hacking around in the quantified self space brought me to personal health, which is basically the idea of using tools (either built by the community or by health & fitness companies) to take charge of our own health. This personal health movement can be thought of one model where care is proactive rather than reactive. All this got me closer to learning about where the healthcare system is really broken and needs technology’s help the most.

    That, of course, brought me to Oscar. I had already known the guys before they got started and I was always excited about the possibilities anytime we got together to talk about the idea of starting an insurance company. If you want, think of my exploration as a see-saw: “things that we do for ourselves” on the left and “things a care provider does for us” on the right. I started on the left and I slowly started learning and moving right. And then I figured I should skip ahead and jump all the way to the right and see the world from Oscar’s perspective.

    I’ve been helping Oscar in various roles: with recruiting for different parts of the team (mainly on the product and engineering sides); with general company “things” (helping with PR/marketing, with process, organizing engineering and recruiting meets, &c.).

    I also spent a lot of time helping build different parts of the product:

    The mobile experience - of course, this one was easy. Many of our members are young and tech-savvy and almost always on their mobile phones. They order food, their cabs, buy movie tickets, read the news, see train times, search for things exclusively on mobile. So why shouldn’t they have a great experience where their healthcare questions and delivery also happens on mobile? I made this a big priority for the team for the January 1st launch: we worked nights and days with a very tiny team. And, in something like eight weeks, we put together a great Oscar Member app for iOS. (Yes, Android at some point very soon!).

    The care finder - this tool can be thought of as your first point of contact when you look to solve an issue in health for yourself or a family member. Instead of blindly Googling for an answer, we imagine that Oscar itself can be your first point of contact. You could even think of it like foursquare’s “Explore”: before you go somewhere, use the search and allow it to pass you to the right spot. The mechanics of how this works are hidden behind the scenes in order to keep the interface simple, but the idea is that it will use basic information about each provider to point you to the right place. Over time, we imagine this system can get better as more data points and views from your friends are added in. “Show me only doctors that can speak Spanish.” – “Go here because many people your age go here.” – “Show me only providers that have many years of experience and happen to be tech-savvy, too.” Why should a health insurance company only step in at the very end of care? (That is: at the point where care has already been delivered and the insurer only steps in to pay your bill for you.) The idea instead is that when you need help, you ask us and we point you to an appropriate place of care that not only solves your needs but also does it transparently.

    The “Doctor on Call” - this one is something we are really proud of and excited about. Some of us were lucky enough to grow up with a family doctor who would be able to answer simple questions over the phone: helping you get care and saving you time from having to drive out to the doctor’s office and taking a couple of hours out of your work day. Whatever happened to those days? Oscar’s “Doctor on Call” does exactly this. We’ve partnered with Teladoc and their physician network to provide this service. So, at any time, no matter where you are (in the U.S.), you’ll be able to ring up a doctor and talk to them about a problem you have. The doctor will be able to recommend a solution, prescribe you medicine or, in cases where a further in-person visit is needed, send you to a specialist to get care. And the best part: all this is free for members. We could have pointed members to independent applications out there now that seem to do this, but we wanted to embed this experience natively into Oscar itself. This way, you never have to leave this ecosystem and use yet another login to use such a system. And by seamlessly integrating this, we could also hide the costs and make it free for you in a much easier way.

    All-in-all, this is just the start of even deeper products and issues Oscar can solve.

    The appeal in Oscar is not only that we get to see through 2014 eyes and solve all the things that incumbents have trouble solving. Or the fact that we can bring a tech-focused approach and solutions to the health care space. To me, the most exciting is that by starting over from scratch, we have the ability to write a new playbook on how a health insurance company should work. We have a chance to provide additional features and services that customers have not expected before. We have the ability to start your care and our relationship with you not after you get hurt and after you’ve been fixed up by the doctor, but rather by being the first point of contact when you do need care. And perhaps, someday, so easy we will even get one step ahead of you and actively alert you to offer you services before you come to realize you need them.

    Building a health insurance company anew from the ground up for the 21st century is a huge undertaking. But one that has consumers and technology (web and mobile) as part of its core value proposition and product strategy is refreshing. The way it should be, as it is done in most other industries.

    -cch

     
  3. nickgrossman:

    "It is trust, more than money, that makes the world go round."
    — Joseph Stiglitz, In No One We Trust

    The week before last, I visited Yahoo! to give the keynote talk at their User First conference, which brought together big companies (Google, Facebook, etc), startups (big ones like USV…

    Great perspective here on how technology enabled networks have disrupted many industries and will continue to do so going forward. Long overdue in health, but innovative change is inevitable and coming.

    -cch

     
  4. In the connected world in which we live, the difference between average content and bad content is hardly noticeable. In fact, the difference between good content and bad content is not that big. Truly, the only thing that really gets rewarded is remarkable content. If you’re investing in content production, always invest in the most amazing, ballsy, exceptional content that you can get your hands on because if you build it, they won’t come. This quote sums things up for me:

    We’ve tried to work longer on stories for greater impact, and publish fewer quick-takes that we know you can consume elsewhere. We’re actually publishing, on average, roughly one-third fewer posts on Salon than we were a year ago (from 848 to 572 in December; 943 to 602 in January). So: 33 percent fewer posts; 40 percent greater traffic – source

    — 

    The Time For Content Marketing Is Now | distilled (via khuyi)

    This is so true.  While I do not wish to slam the host of startups that are looking to automate “content marketing”, the fact is that great, original content:

    1) Takes time

    2) Requires vision

    3) Necessitates risk

    That is not something that can be created by a bot.  It is not something that an algorithm can replace or make more efficient.  While cultivating a strategy and ethos of quality content may not yield the quick hits or instant recognition, in the long run it is a strategy that will yield the greatest gains.

    (via marksbirch)

    Great insight here.
    Don’t post just to post. Have meaning behind your content so others can pick up the signal in the midst of all that noise.

    -cch

     
  5. image: Download

    marksbirch:

WHERE DO STARTUPS WORK IN NYC?
The explosion in co-working and accelerators over the past five years has been remarkable.  To keep track of all of these locations, I put together a list in 2010 that quickly became outdated, so I put together a new list of NYC Accelerators, Incubators, and Co-working spaces in 2012 that I regularly update (if I missed any, please let me know!)
There are also several other great resources provided by NYCEDC, Crain’s NYC (and a nifty map), and Charles Bonello with more detailed information than my simple directory.  The great thing is that if you are looking for an office or facility to work out of, you have an enormous selection to choose from with over 100 working spaces covering a wide breadth of industries from arts to biotech to food to tech.  It truly is a great time to start a company here in NYC with the variety and affordability of office space throughout the metro area.
If you have a hankering for starting up someplace else however, you might want to check this global directory of accelerators and incubators on LAUNCH.  We still think NYC is best though!
nycedc:

In 2008, New Work City launched the first co-working space in NYC which provided office space for people who work from home, freelancers, and entrepreneurs. Today, there are over 100 co-working spaces in the City including incubator and accelerator programs with even more on the way. Read more at Crain’s

“(Incubators) are tapping into incredible demand from entrepreneurs and from people in a freelance economy. From the city’s perspective, with the Wall Street meltdown in 2008, it became incredibly clear that Wall Street was not going to save the day and that New York really needed to add balance to its economy and identify a new source for growth.”
- Jonathan Bowles, the executive director of Center for an Urban Future.

Learn more about some of the incubator spaces available here in NYC.


Great list of NYC start-up work places and resources here. Also excited to see some familiar friends and new ones this evening while judging finalist start-ups at the NYCEDC Innovate Health Tech NYC 2013 Demo Day at We Work Labs in SoHo! -cch

    marksbirch:

    WHERE DO STARTUPS WORK IN NYC?

    The explosion in co-working and accelerators over the past five years has been remarkable.  To keep track of all of these locations, I put together a list in 2010 that quickly became outdated, so I put together a new list of NYC Accelerators, Incubators, and Co-working spaces in 2012 that I regularly update (if I missed any, please let me know!)

    There are also several other great resources provided by NYCEDC, Crain’s NYC (and a nifty map), and Charles Bonello with more detailed information than my simple directory.  The great thing is that if you are looking for an office or facility to work out of, you have an enormous selection to choose from with over 100 working spaces covering a wide breadth of industries from arts to biotech to food to tech.  It truly is a great time to start a company here in NYC with the variety and affordability of office space throughout the metro area.

    If you have a hankering for starting up someplace else however, you might want to check this global directory of accelerators and incubators on LAUNCH.  We still think NYC is best though!

    nycedc:

    In 2008, New Work City launched the first co-working space in NYC which provided office space for people who work from home, freelancers, and entrepreneurs. Today, there are over 100 co-working spaces in the City including incubator and accelerator programs with even more on the way. Read more at Crain’s

    “(Incubators) are tapping into incredible demand from entrepreneurs and from people in a freelance economy. From the city’s perspective, with the Wall Street meltdown in 2008, it became incredibly clear that Wall Street was not going to save the day and that New York really needed to add balance to its economy and identify a new source for growth.”

    Jonathan Bowles, the executive director of Center for an Urban Future.

    Learn more about some of the incubator spaces available here in NYC.

    Great list of NYC start-up work places and resources here. Also excited to see some familiar friends and new ones this evening while judging finalist start-ups at the NYCEDC Innovate Health Tech NYC 2013 Demo Day at We Work Labs in SoHo!

    -cch

     
  6. image: Download

    marksbirch:

Having grown up in Brooklyn, I would never have imagined that tech would be a booming industry.  Incredible and inspiring to see…
nycdigital:

The Brooklyn Tech Triangle is working together to grow the tech and creative community.  A strategic plan was released by the Brooklyn Tech Triangle coalition to help make NYC the leading tech hub in the nation.  The strategy includes calls for enhancing workforce development, increasing availability of affordable real estate, improving transportation and more.  The plan focuses on areas in Downtown Brooklyn, DUMBO and the Brooklyn Navy Yard.  Read the full plan at http://brooklyntechtriangle.com


Here’s to good things happening in #Brooklyn! -cch

    marksbirch:

    Having grown up in Brooklyn, I would never have imagined that tech would be a booming industry.  Incredible and inspiring to see…

    nycdigital:

    The Brooklyn Tech Triangle is working together to grow the tech and creative community.  A strategic plan was released by the Brooklyn Tech Triangle coalition to help make NYC the leading tech hub in the nation.  The strategy includes calls for enhancing workforce development, increasing availability of affordable real estate, improving transportation and more.  The plan focuses on areas in Downtown Brooklyn, DUMBO and the Brooklyn Navy Yard.  Read the full plan at http://brooklyntechtriangle.com

    Here’s to good things happening in #Brooklyn!

    -cch

     
  7. continuations:

    At the height of the re-engineering craze there was one fantastic HBR article titled “Re-engineering Work: Don’t Automate, Obliterate.” In light of the changes in the labor market the choice of “obliterate” may now seem unfortunate, but the basic point of the article was spot on: don’t implement…

    Nice read and perspective here on innovation and competitive advantage, for both young and big mature companies alike. The trick of course, is to SUSTAIN competitive advantage in the face of fluid and rapidly changing technology and market forces (including regulation/policy and macroeconomic condition of the financial markets, domestic and international).

    -cch

     
  8. Data, Design, Diabetes innovation challenge, Wednesday 05/16 @ the Blueprint Health offices in NYC!  And don’t forget for those healthtech or digital health innovators out there, Blueprint is accepting applications now for the 2nd accelerator class starting July 23rd.

    Spread the word… diabetes is a huge problem impacting our country on so many levels, and we need people from multidisciplinary backgrounds involved in helping develop solutions!

    -cch

    startuphealth:

    Data Design Diabetes is a next-generation challenge that casts a wide net to the innovator community to find a breakthrough in improving the quality, delivery, and cost of care, to help millions of Americans living with diabetes. Demo Day will provide an opportunity to learn more…
     
  9. Blueprint Health Demo Day

    The @bphealth teams have been working hard, if you’re in NYC later this month and interested in HealthTech innovation, come on by! -cch

    startuphealth:

    On Thursday, March 29th - come meet 20 amazing healthcare entrepreneurs who are twelve weeks into building and growing successful healthcare businesses. Join us at Blueprint Health’s SoHo loft as we showcase the inaugural class of Blueprint Health companies and celebrate the rise of NYC as a healthcare innovation hub. Request an invite here.  Space is limited.

     
  10. Just came across this quick interview by Malcolm Gladwell discussing innovation frameworks and ideas broadly, and then specifically as they relate to healthcare.  Very good food for thought and well worth the 10 minute perspective he offers.  He’s a famous author of course, and if you haven’t read them - after you watch this short video you won’t be surprised that his books are also very thought-provoking and worth the time to check out and digest.  

    -cch

     
  11. image: Download

    Great health topics and concepts curated from the always forward thinking Jay Parkinson.
Jumps around a bit topic-wise, but nonetheless very worthwhile to take time to read, digest, and think about the implications for health innovation in 2012+. 
-cch
jayparkinsonmd:

My (health) best of 2011.
One of the questions I ask doctors is “In the past 10 years, what is an innovation that has revolutionized medical practice?” Most of them can’t answer. From a medical perspective, we’re simply stuck with tiny, incremental changes that may or may not change our health for the better. So, with that in mind, I’ve tried to choose the most important health concepts from the past 12 months. Some of them are from other people. Some of them are my own thoughts. Some of them are simply important moments in my own personal health. In no particular order:
Trials and Errors: Why Science is Failing US

Although the scientific process tries to makes sense of problems by isolating every variable—imagining a blood vessel, say, if HDL alone were raised—reality doesn’t work like that. Instead, we live in a world in which everything is knotted together, an impregnable tangle of causes and effects. Even when a system is dissected into its basic parts, those parts are still influenced by a whirligig of forces we can’t understand or haven’t considered or don’t think matter.

How Doctors Die
The nation’s “best” hospitals aren’t even in the top 400 list of safest hospitals.

In the latest advance for health care accountability, the country’s leading hospital accreditation board, the Joint Commission, released a list on Tuesday of 405 medical centers that have been the most diligent in following protocols to treat conditions like heart attack andpneumonia. Almost without exception, most highly regarded hospitals in the United States, from Johns Hopkins in Baltimore to the Mayo Clinic in Rochester, Minn., did not make the list.

Food Stamps Are Now Worth Double at Farmer’s Markets in Michigan
Real Food is Cheaper than Junk Food
The Easy Way to Stop Smoking
The Hazards of the Couch
The Hot Spotters
A Food Manifesto for the Future
Most Health Solutions Aren’t Medical, They’re Social
Weighing the Evidence on Exercise:

It is extremely unlikely that using exercise or a diet alone will lead to long-term weight loss.Exercise makes you hungry because your body wants to maintain its current state. Guard against eating more because you’re exercising.  Start eating real food and less calories— understand that this is how you will eat from now on. Start exercising. Once you hit your weight goal, continue exercising. Don’t stop. If you don’t change anything about your life, you’ll never weigh less than you do now.

What Happens to Doctors Who Think Outside the Box?
Family Planning as a Cost-Saving Preventive Health Service 

The cost of one Medicaid-covered birth in the United States (including prenatal care, delivery, postpartum care, and infant care for 1 year) was $12,613 in 2008, according to estimates from the Guttmacher Institute. The national per-client cost for contraceptive care the same year was $257. In 2008, an estimated $1.9 billion was spent on publicly funded family-planning care — an investment that resulted in an estimated $7 billion in Medicaid savings for the cost of unplanned births.

Coffee vs. Migraines
RIP Dr. Kevorkian
RIP Jack LaLanne
A Measure of My Days: The Journal of a Country Doctor:

Health is not a commodity. Risk factors are not disease. Aging is not an illness. To fix a problem is easy, to sit with another suffering is hard. Doing all we can is not the same as doing what we should. Quality is more than metrics. Patients cannot see outside their pain, we cannot see in, relationship is the only bridge between. Time is precious; we spend it on what we value. The most common condition we treat is unhappiness. And the greatest obstacle to treating a patient’s unhappiness is our own. Nothing is more patient-centered than the process of change. Doctors expect too much from data and not enough from conversation. Community is a locus of healing, not the hospital or the clinic. The foundation of medicine is friendship, conversation and hope.

Wild Food: A tumblr I started because most people have no idea what their food looks like as it’s growing.
Buddycare vs. Humancare
Vaccines Save Lives. End of Story. Part 1 and Part 2.
Everything in Your Environment is Set Up for the Way You Were Before
Introducing my new company, Sherpaa. Launching in just a few weeks.
Doctors of the Future:

We’re a tribe of forward-thinking creative doctors.And we know that the future of healthcare depends on us.We’re the leaders of this revolution.Intrigued? You should be.

One of the best things to happen to me.
Photo by me from many years ago on New Years Eve at Madison Square Garden while listening to Wilco ring in the new year.

    Great health topics and concepts curated from the always forward thinking Jay Parkinson.

    Jumps around a bit topic-wise, but nonetheless very worthwhile to take time to read, digest, and think about the implications for health innovation in 2012+. 

    -cch

    jayparkinsonmd:

    My (health) best of 2011.

    One of the questions I ask doctors is “In the past 10 years, what is an innovation that has revolutionized medical practice?” Most of them can’t answer. From a medical perspective, we’re simply stuck with tiny, incremental changes that may or may not change our health for the better. So, with that in mind, I’ve tried to choose the most important health concepts from the past 12 months. Some of them are from other people. Some of them are my own thoughts. Some of them are simply important moments in my own personal health. In no particular order:

    Trials and Errors: Why Science is Failing US

    Although the scientific process tries to makes sense of problems by isolating every variable—imagining a blood vessel, say, if HDL alone were raised—reality doesn’t work like that. Instead, we live in a world in which everything is knotted together, an impregnable tangle of causes and effects. Even when a system is dissected into its basic parts, those parts are still influenced by a whirligig of forces we can’t understand or haven’t considered or don’t think matter.

    How Doctors Die

    The nation’s “best” hospitals aren’t even in the top 400 list of safest hospitals.

    In the latest advance for health care accountability, the country’s leading hospital accreditation board, the Joint Commission, released a list on Tuesday of 405 medical centers that have been the most diligent in following protocols to treat conditions like heart attack andpneumonia. Almost without exception, most highly regarded hospitals in the United States, from Johns Hopkins in Baltimore to the Mayo Clinic in Rochester, Minn., did not make the list.

    Food Stamps Are Now Worth Double at Farmer’s Markets in Michigan

    Real Food is Cheaper than Junk Food

    The Easy Way to Stop Smoking

    The Hazards of the Couch

    The Hot Spotters

    A Food Manifesto for the Future

    Most Health Solutions Aren’t Medical, They’re Social

    Weighing the Evidence on Exercise:

    It is extremely unlikely that using exercise or a diet alone will lead to long-term weight loss.
    Exercise makes you hungry because your body wants to maintain its current state. Guard against eating more because you’re exercising. 
    Start eating real food and less calories— understand that this is how you will eat from now on.
    Start exercising. Once you hit your weight goal, continue exercising. Don’t stop.
    If you don’t change anything about your life, you’ll never weigh less than you do now.

    What Happens to Doctors Who Think Outside the Box?

    Family Planning as a Cost-Saving Preventive Health Service

    The cost of one Medicaid-covered birth in the United States (including prenatal care, delivery, postpartum care, and infant care for 1 year) was $12,613 in 2008, according to estimates from the Guttmacher Institute. The national per-client cost for contraceptive care the same year was $257. In 2008, an estimated $1.9 billion was spent on publicly funded family-planning care — an investment that resulted in an estimated $7 billion in Medicaid savings for the cost of unplanned births.

    Coffee vs. Migraines

    RIP Dr. Kevorkian

    RIP Jack LaLanne

    A Measure of My Days: The Journal of a Country Doctor:

    Health is not a commodity. Risk factors are not disease. Aging is not an illness. To fix a problem is easy, to sit with another suffering is hard. Doing all we can is not the same as doing what we should. Quality is more than metrics. Patients cannot see outside their pain, we cannot see in, relationship is the only bridge between. Time is precious; we spend it on what we value. The most common condition we treat is unhappiness. And the greatest obstacle to treating a patient’s unhappiness is our own. Nothing is more patient-centered than the process of change. Doctors expect too much from data and not enough from conversation. Community is a locus of healing, not the hospital or the clinic. The foundation of medicine is friendship, conversation and hope.

    Wild Food: A tumblr I started because most people have no idea what their food looks like as it’s growing.

    Buddycare vs. Humancare

    Vaccines Save Lives. End of Story. Part 1 and Part 2.

    Everything in Your Environment is Set Up for the Way You Were Before

    Introducing my new company, Sherpaa. Launching in just a few weeks.

    Doctors of the Future:

    We’re a tribe of forward-thinking creative doctors.
    And we know that the future of healthcare depends on us.
    We’re the leaders of this revolution.
    Intrigued? You should be.

    One of the best things to happen to me.

    Photo by me from many years ago on New Years Eve at Madison Square Garden while listening to Wilco ring in the new year.

     
  12. (Overdue) thoughts on mHealth…

    mHealth

    At the beginning of December, the 2011 mHealth conference took place in Washington DC.  For conference attendees, it was a chance to be lost amongst thousands of others in the cavernous Gaylord National Resort & Convention Center (sans WiFi or conference supplied beverages, not to mention snacks/meals) and hear about the intersection of technology, business, research and policy.  For those that weren’t able to attend in person, and prefer watching versus reading - most all of the conference sessions were recorded and the videos have been graciously posted for free viewing here.  There have been quite a few posts written by attendees in recent weeks, and among the good ones I’ve read, John Moore’s summary from Chilmark Research is (per the usual) pretty straight forward and spot-on.

    Regardless, I promised a few folks who couldn’t make it my thoughts on the conference, the topic of “mHealth”, and broader health & technology trends in general.  So here are my (overdue) main takeways and thoughts: 

    1) We should hope for the death of “mHealth"… and soon!

    death

    • I’m not saying this simply to be controversial and say so with the utmost respect for the visionary folks behind the mHealth movement and the vibrant ecosystem that has spawned as a result.  However, smarter folks than me (including some guy named Todd Park who’s the CTO of HHS) have stated this in public.  But you might wonder why this would be my first takeaway, on the heels of the largest and most well attended mHealth summit ever (~3,700 attendees), the thick 75 page program guide, and 95 presentations recorded and thought-provoking videos posted?  Simply put, mHealth needs to be embedded within normal healthcare delivery.  At present, it suffers from the specialization and sub-specialization endemic within the healthcare profession which results in hyperfragmentation and discrete, often uncoordinated provision of services (there are ~50 main medical specialties, with about 1/2 having ~4-6 further subspecialties). Most mHealth companies (and products and services) are tackling thin vertical healthcare opportunity slices instead of being part of an integrated, horizontal package of care and value delivery.  Part of this is due to larger systemic forces; as Dr. Atul Gawande points out, there are ~14,000 known diagnoses, ~4,000+ medical surgical procedures, and ~6,000+ medications in the world today.  While those who know me know that I am a fan of any type of healthcare innovation, this hyperfragmentation doesn’t really help the industry from a holistic macro perspective (i.e. tackling one or more of the big three issues: improved efficiency, improved outcomes, reduced costs).  There are those who argue that integration of standalone mHealth technologies, products and services requires common standards and protocols, and that such collaboration must be fostered and facilitated by the government.  While the government can certainly catalyze standardization for device-to-device communication and integration, private entities can play a role as well.  The not-for-profit West Wireless Health Institute for example is working with a number of healthcare stakeholders (public and private) to develop a common infrastructure and framework along these lines, starting with their Infrastructure Independence initiative.  The sooner the term “mHealth” and all its associated forms goes away and gets folded and integrated into standard healthcare delivery, the better for the healthcare industry (and economics) of our country. 

    2) The immediate mHealth opportunities aren’t in apps, they’re in platform connectivity and data synthesis.

    Wireless sensors

    • Look, mobile apps are hot and ubiquitous, I get it.  But guess what?  Most consumers (beyond the Technoratti, the Quantified Self and Health 2.0 geeks) don’t care about their health enough to download health apps, less use those apps regularly (at least several times a week at the minimum, ideally daily).  Health apps aren’t even in the top ten of downloaded app categories for consumers: games, weather, and social networking top the list.  Health apps come in with a rank of #17 for consumers.  What about providers you ask?  Well, over 85% of healthcare professionals don’t use the apps they have downloaded - there is definitely app overload for providers and consumers alike.  So even though there are now ~12,000 health apps in the Apple store, you’re competing with literally tens of thousands of games.  And no, the solution is not “to gamify” or the “gamification” of mHealth or health apps.  The immediate value opportunities are in platform connectivity and data synthesis.  There are a myriad of mobile devices and sensors out on the market, consumer and provider targeted, fragmented and discrete for the most part as previously noted.  Ingesting the data being collected and transmitted by these proliferating devices and simply connecting them to decision support tools, and EMRs is a huge opportunity.  It might not be as sexy as a direct to consumer mobile app, but working with enterprise customers to more efficiently deliver care and improve outcomes in a timely manner solves a tremendous point of pain for providers and payors now and going forward in a world of changing risk and payment models (capitation, bundled payments, ACOs, etc).  Connectivity and then data (big or not) synthesis and analytics are clear opportunities for innovation.  Those that play in this space, probably aren’t accurately labeled or silo’ed as mHealth companies, but should be considered broader healthtech ones and for good reason.  

    3) The U.S. mHealth should learn from emerging market mHealth innovation models!

    Emerging market cell phones

    • John Moore touched on this in his mHealth Chilmark post, and I’d like to believe we share this view perhaps because of our side conversation in the hallway during the Monday session around what we thought was good so far at the mHealth summit earlier this month (and I’ve written about this before) - but we both thought that the emerging market tracks were of keen interest and value.  So what’s so compelling about emerging market mHealth innovation?  To me, it’s around distribution (a big N) and engagement (how often does that N use your product).  An mHealth post by a well known healthcare VC stated her opinion that it was a bit weird to see MNOs like Verizon and AT&T have strong presence and presenting at mHealth.  I’m scratching my head as to why this would seem odd, because it appears plainly obvious to me.  MNO’s (mobile network operators) and their devices are integral parts of the lives of those who live in emerging markets.  There are more cell phones than landlines in most of these areas, and therefore cell phones are used not just for communication, but for financial transactions and currency.  It’s a big market as well, an estimated $200 billion market for cell phone airtime in developing countries.  In short, in emerging markets most people have cell phones (the distribution N), and depend on their cell phones for daily acts of life (the engagement).  Combine this with health initiatives, it’s no surprise that in emerging markets, MNOs play an integral role in mHealth because of their device distribution and daily utilization - and they achieve this often times using 1G networks and feature phones!  With the ubiquity of smartphones in our LTE and 4G developed world, it makes complete sense to have MNOs play a more active role in mHealth in the US.  There are now more mobile devices (~328 million) in the US and it’s territories than people (315 million) which means that many people in our country have not just 1 mobile device, but several technology enabled mobile gadgets!  The MNOs are (typically) device and company agnostic: Apple or Samsung or HTC, smartphone or tablet, the MNOs simply want to push these products into consumers hands and then have consumers be dependent upon the MNOs for all the associated data consumption and service needs through these devices.  In addition, beyond solving the distribution question of devices, MNOs are in a unique position to leverage clear incentives for health use/engagement (additional data service credits, additional cell phone airtime minutes, free downloads from their app stores, etc.) and can even pre-install health apps, eliminating the friction associated with app discovery and downloads.  Having MNO’s play a big role going forward in mHealth and healthcare period here in the US seems pretty much like a no-brainer to me, but perhaps I’m way off the reservation on this one.  WellDoc, who was at mHealth, and their MNO partnership with AT&T is a prime example of a forward thinking mHealth company working to advance diabetes care with some great results thus far.  MNOs can, will, and should play an increasingly bigger and important role in mHealth in the US, not simply because of their communications infrastructure and bandwidth, but because of the prevalence of the devices they distribute which are basically human appendages at this point for most consumers, starting at earlier and earlier ages (the average age for kids who receive first cell phones is now down to less than 12 years of age).  Even assuming annual cell phone service expenditures in the US has remained at 2007 levels (~$610), this implies a current US market size of $200 billion for cell phone services given ~328 million mobile devices on the market.   Health/technology VCs (including the prior one mentioned previously) have commented on the lack of excitement around the projected $400M market for mhealth smartphone applications and services (and there was a VC panel at mHealth whereby panelists posited that the odds are low on whether there could be a billion dollar+ mHealth company), and this is a fair opinion if this discrete view is taken of “mHealth”.  However, perhaps a better rough estimate of the future market potential might be achieved by approximating if just 1% of annual US cell phone service expenditure was dedicated to health, then this results in a $2 billion dollar annual opportunity which certainly should be a bit more appealing for startups and investors alike.   The other lesson to be learned from emerging markets, I believe, is the simple distillation of healthcare problems, and the functional, utilitarian solutions that can be created to solve them without the latest technological gadgets and attempts at (shudder) “gamification”.  This can be easier said than done, as Steve Jobs said, “Simple can be harder than complex”, but perhaps the technological constraints associated with emerging markets has helped foster simple innovative solutions. 

    Those are my main (overdue) mHealth thoughts…  as always, happy to chat further about any of these viewpoints and health/tech data innovation period.

    -cch

     
  13. Things to think about when considering accelerators…

    Innovation

    This post is a bit overdue, but given that I have been spending a bunch of time recently thinking about innovation and start-ups, I wanted to share some more thoughts around start-up accelerators and incubators in general, but specifically as it relates to what I will call the new crop of “HealthTech” accelerators that have popped up recently: Blueprint Health (NYC), Health Box (CHI), and Rock Health (SF) and to some extent, Startup Health (NYC), although Startup Health is aiming to be more of an accelerator academy for more established start-ups past seed stage (whereas the first three are more seed stage accelerators).  This is a follow-up blog post of sorts to my guest post for Pulse & Signal a few months ago as part of the sanofi-aventis Data, Design, Diabetes 2011 challenge (for which I was a mentor for). 

    But before sharing, a few disclaimers:

    Disclaimer #1 - I am a mentor/adviser to Blueprint Health, but also know Halle Tecco and Nate Gross from Rock Health since last year when they were working on the idea as part of an HBS 2nd year field study with Bob Higgins, and I also know Steve Krein of Startup Health. 

    Disclaimer #2 - I strongly believe that we are at a time for the rise of a strong and emerging ecosystem for health and technology start-ups and innovation, given a lot of recent macro factors emerging for this complex healthcare industry and the general macro trends of the past 3-5 years in technology.  To this extent, as it relates to the healthtech accelerators mentioned above specifically and other accelerators out there generally, I (personally) don’t view it as a “US vs. them” zero-sum game… I believe in collaboration and an “all boats will rise” philosophy and approach.  I know many folks in this healthtech ecosystem who (rightly or wrongly) share this view, and perhaps because we’re pragmatic and are fans of anyone that is innovating in this space and helping to improve the healthcare industry - it’s frankly unrealistic to believe there will be a single magic bullet to cure all of this industry’s ills, and we need as many smart and passionate people/start-ups tackling the many problems in the US healthcare industry. 

    So… lately, there has a been a lot of buzz around healthtech accelerators.  This is very much due to the “success” of tech start-up accelerators such as Y Combinator and TechStars over the past years.  These accelerators have focused primarily on tech or digital start-ups, and although a few healthcare related companies have gone through their programs, healthcare certainly isn’t the core program focus or draw.  Realizing that healthcare is a slightly different and complex industry (quick: name a few other industries where it’s “standard” that the main customer/recipient of services doesn’t pay for 100% of the bill at the time services are rendered), it’s great that TechStars and some others not only realize this healthcare complexity, but also desire to promote innovation in this unique and important industry and therefore are supporting health industry specific accelerators (Blueprint Health is a charter member of the TechStars network).  A bunch of health start-up companies I’ve come across and have had discussions with the past few months have asked me about more information on these healthtech accelerators, including the differences between, and the pro’s/con’s of one versus another.  

    So, I figured it’s worth sharing my advice around things to think about when considering accelerators here for anyone to read (hopefully it’s of some value), which basically boil down to three important things you should determine for each program:

    Fit

    1) FIT: Is your start-up a fit for the accelerator, in terms of your team’s experience, stage of your company, and geography.  Most accelerators are geared towards first time entrepreneur teams and early stage companies.  Team is important, and usually means at least two people are working full-time on the NewCo.  Early stage typically means you have both an idea and a product/service to show (even if in alpha or beta), and have raised some friends/family money to get the idea off the ground.  Note - there is no exact rule around how much money raised is needed or is too much for an accelerator; my friend Jason Baptiste of OnSwipe had already raised over a $1M in seed money but still decided that TechStars NYC was a worthwhile program to enter in order to help accelerate the company.  In terms of geography, the right, middle, and left coasts are each represented for the main healthtech accelerators, and this is an important consideration depending on where the current NewCo is based, and whether three months onsite in an intensive accelerator program is feasible for all the team members, particularly if it’s a new city.  

    Track record

    2) TRACK RECORD - Program & People: When determining which accelerators are worth applying for, be sure to check out the track record in terms of past program classes and their outcomes.  Not all seed stage start-ups succeed, and not even the best early stage Series A and B VC firms bat 1.000 in terms of each of their investments resulting in a successful exit.  But both TechStars and Y Combinator do a great job of providing clear and transparent data on how their incubated companies are doing, as evidenced by this information from TechStars.  Beyond looking at objective quantitative data, be sure to talk to some past program participants around their experience.  The main question to ask them is whether they thought the program experience was beneficial to them as a company and as entrepreneurs.  If the program accelerated the path of the NewCos more often than not in a material way (each company’s experience of course will be slightly different), and/or imparted some great learnings and experiences for the participants (either for this start-up or one later down the road), the program graduates should say that the small equity dilution (if any) is well worth it (if they even bring it up at all).  

    Now, it can be hard to assess program track record for new accelerators such as these new healthtech ones.  For Health Box and Rock Health, you should of course ask current or past program participants if they got value out of the program and their experience.  But absent an established program track record, you should move to diligence the track record of the program’s people.  As most who’ve been involved with early stage start-ups and investing know, when push comes to shove, team is usually one of the most important, if not the differentiating factor.  Now no one single person makes a company and can do it all themselves.  And while the people involved with the program won’t do your job for you, it is important to determine their track record.  Find out who is involved, day in and day out, as the program’s directors and staff and find out what their backgrounds are, i.e. do they have relevant experience in health or technology start-ups, investing, and innovation?  Determine if they possess not just deep and relevant domain expertise, but what their reputations are in terms of other start-ups, investors, and thought-leaders in the industry.  Finally, figure out if they are well connected within the industry’s innovation community (the types listed above, but also including customers and media).  You should also diligence who is part of the program’s surrounding ecosystem and community, in terms of the sponsoring companies, mentors, and investors.  Ideally get in touch with a few, and ask them why they are involved, what is their understanding of the program, and how/what they will contribute.  Ask them frankly if they are in it for the long haul and believe in the space (or is this just a short-term and “hot” area they want to be involved in).

    Substance

    3) SUBSTANCE: Determine what the program will offer you, in terms of structure, resources, and content.  There is no secret sauce to what ingredients are necessary to bring together to result in a big and successful company, but relevant topics and experts include: legal, marketing/PR, programming, UI/UX design, business and revenue models, HR/team building, ops/real estate, finance/investing, and customers.  Y Combinator clearly states what happens in their program and what program participants can expect.  Be sure to determine whether it is a program of substance instead of flash.  The track record of the program and the main people involved will help determine whether an accelerator might be a worth applying to.  A way of helping determine a program’s substance is finding out what their philosophy or mission statement is (or if they have one!).  

    Finally - the ultimate consideration is whether you believe a specific accelerator can help speed up your NewCo’s growth and development in three intense months as opposed to figuring it out on your own.  An analogy might be continually running the football to advance your company down the field versus trying pass plays.  Running the football can get you down the field eventually, but you can cover more ground quicker by airing it out and throwing downfield.  A start-up accelerator can help with the latter, but it’s certainly not for everyone. While applications to these accelerators can vary in terms of length and complexity, it’s worth it to do your homework and diligence whether the Fit, Track Record (of the program and it’s people), and Substance are worth applying to.  Applying and enrolling certainly shouldn’t be done haphazardly!  But if, for whatever reason, you don’t think you are ready now for a program’s class, take time to think about it and compile some more diligence, and consider applying for the next program class as hopefully these healthtech accelerators (and others) will be around in the years to come! 

    As always, I welcome any thoughts and comments!  Especially if there are other established healthtech accelerators out there!

    -cch

     
  14. Behind the scenes of a virtual health & tech incubator (& other thoughts)

    Below is my guest post on Pulse & Signal (a public health blog) from Sept. 14, 2011 as part of the 2011 Data, Design, Diabetes (DDD) Challenge which I was a mentor for.  The post was originally written in advance of the DDD demo day, after which two of the five semi-finalists were selected as finalists to continue with the Challenge with the chance to win the main prize (the winner will be announced in the next few weeks).  The post is meant to crystalize and explain the experience of the DDD incubator, which was in many ways similar to some of the tech accelerator/incubator programs out there, but in other ways different.  In any event - it was a fantastic program and all five semi-finalists had great ideas for innovation in diabetes involving design and data.  Congrats to all, and good luck to the remaining two finalists for the $100k prize: Chewable and Ginger.io.   And stay tuned for more exciting things in health & technology innovation through incubators and accelerators this winter, with the launch of Blueprint Health's and Startup Health's 1st program classes in New York in January, along with Rock Health's 2nd program class in San Francisco.  Oh - and it should be noted that all of these health & tech organizations (including Startup Health thanks to a friendly reminder from Unity Stoakes) have some tie to Boston/New England, mainly through the great universities there.  Just sayin. :)

    -cch 

    Laptop writing

    It  is an exciting time to be an entrepreneur these days.  President Obama earlier this year launched aStartup America initiative to promote entrepreneurship in America, citing the need for the US to maintain its competitiveness in international business through tech innovation and superiority in particular.  For those that are tech enthusiasts, i.e. those in Silicon Valley, the importance of technology start-ups and entrepreneurship isn’t a new fad.    Start-up technology accelerator and incubator programs, such as TechStars and Y-combinator, have been around since the mid 2000’s to help entrepreneurs grow businesses from ideation to product development and launch.   Thanks to President Obama and Congress, who passed the HITECH Act in March 2009 and Affordable Care Act in March 2010, there is now also great interest in the intersection of health and technology innovation, aided by the billions of dollars earmarked for technology adoption by health care providers and health insurance companies.  This interest in “healthtech” is further evidenced by the recent creation of health technology specific incubators all across the country such as New York’s Blueprint Health, Chicago’s Healthbox, and San Francisco’s Rock Health.

    It should be noted that established health care and life science companies are also re-thinking how they innovate beyond their own four walls to better leverage technologies that aren’t native to their industries, such as mobile, digital and social media, the Internet, cloud-computing, etc.  The 2011 sanofi-aventis U.S. Innovation Challenge: Data, Design, Diabetes (DDD) is such an example of a life science company spurring innovation through a public and crowd-sourced challenge with financial rewards and a virtual incubator that was previously introduced here.  The challenge was announced on June 9, 2011 in DC, and has a Demonstration Day for five semi-finalists in New York this Thursday, September 15 in NYC (anyone interested in health and technology innovation, particularly diabetes, is welcome to attend the DDD Demo Day, as it is free and open to the interested public).

     There are seven core components of these start-up incubator programs:

    1. Application
    2. Guaranteed fixed funding (for those start-ups who are accepted)
    3. Physical co-location
    4. Limited program timeframe
    5. Rapid iteration and innovation
    6. Close mentorship and guidance
    7. Demonstration (“Demo”) Day upon program culmination

    I will touch on each of these seven components as it relates to DDD, but will expound a bit deeper on the last three components, which I would argue are the more exciting elements of the program (in particular the upcoming Demo Day). The DDD challenge incorporates virtually all of these elements with one exception outlined below.   Regarding the first component, the competition accepted applications via its website July 1 through July 31, and five semi-finalists were chosen from the pool of applications and announced August 5.  The second component (fixed funding) of DDD is explained simply here on the DDD homepage, but the total prize money to be awarded is $210,000. The third component is the only element not fully incorporated within the DDD challenge, as the program is a virtual incubator and did not provide physical office space nor require that the five semi-finalists be co-located together in New York.  A limited time frame, or the fourth component of incubator programs is an attribute of DDD, as the five semi-finalists and mentors collaborated from August through September in the virtual incubator, and a detailed timeline of the overall challenge can be found here.

    Rapid Iteration and Innovation: Any accelerator or incubator program encourages very rapid development of product or service prototypes.  This is partly because these programs are a fixed and limited duration (i.e. typically 12 weeks from program start to demo day).  Teams therefore need to work long, hard, and fast to get to Demo Day.  While start-up life truly is a marathon, these programs are intended to be sprints and as anyone knows, you can’t sustain sprints for a long duration of time.  Therefore, rapid development of prototypes is encouraged.  Perfection isn’t always achieved nor desired within this complex time frame – but quick trial and error is a goal.  This core tenant of lean start-ups is endorsed by Eric Ries, who has written several books around “Lean Startups”, as evidenced by a recent blog post of Eric’s called “The Power of Small Batches” (which is borrowed from his most recent book).

    The DDD teams I’ve interacted with over the past few weeks as a mentor all have a fairly robust and long product development wish-list or roadmap.   What they have all had to do throughout this program is:

    • Determine which core product features they could reasonably develop  for their platform or service offering in the time available prior to Demo Day
    • Prioritize those core features
    • Rapidly develop those core features
    • Test those features

    Close mentorship and guidance:  It is true that the barriers to starting a company, particularly a technology based company are very low these days.  Not only is it financially easier to say, start and launch a business website and build mobile apps, but there is an abundance of free or low cost knowledge and resources such as coder and hacker communities, seed/angel/VC investors, entrepreneur/start-up communities that can be accessed in real life or online by leveraging the Internet. As a result, there are those that question the value of start-up accelerators, but to be clear – they are not intended for every entrepreneur, they do not guarantee overnight or ultimate success for the start-up, and aren’t required to launch and grow an innovative and meaningful company.  Most incubators are intended primarily for young or first time entrepreneurs.   However, it should be noted that the DDD challenge and its virtual incubator model is slightly different than pure tech accelerators, in that it was constructed to encourage broad innovation in diabetes through the combination of data and design, and encourages all entrepreneurs, young and old, to endeavor in this important area.   What the DDD challenge and tech accelerators do share is the reliance on a strong mentor community to help nurture the start-ups in the program. The quality, accessibility, and diversity of mentors define and distinguish how valuable an experience is going through one start-up accelerator versus another.

    David Tisch, the Managing Director of TechStars NYC and I have shared conversations around what is the right metric of success for Managing Directors or Partners of accelerators – and ultimately it’s whether the entrepreneurs think they got value from the program, not so much in terms of the actual financial capital they received (and whether it was dilutive or not from an ownership perspective), but from the guidance they received from mentors, from the development and growth of their start-up during the program, and whether it was simply time well spent.  Mentors can’t and won’t do everything for your start-up to succeed, but can help you think through the pros and cons of business or product strategy, link you up with other domain experts and potential investors, and push you and your team to work smarter and faster.  At the end of such an accelerator program, if the program has been developed thoughtfully by its managing directors or partners (usually these accelerator programs are run by seasoned entrepreneurs with significant domain expertise and/or early stage investors) and the assembled cast of mentors do their job right, the graduating start-ups will provide testimony to the benefit of the accelerator; they should be fanatical ambassadors for that program’s brand and attest to its value.  They and their business will have found their way in a much shorter period of time than if left on their own to figure things out.

    Demo Day: This is the graduation ceremony for the start-ups of an accelerator program.   It is the culmination of weeks of hard work and long hours.  It is a celebration, whereby the companies show the world the progress they have made in the past few months of the program.  An audience of journalists, investors, start-ups, and other people and companies interested in start-ups and innovation will be in attendance to learn more about these start-up companies who up until that point, might have been in stealth mode or have been figuring out the right product mix, business partnerships, go-to-market (GTM) strategy, and business model.  Each company gets a few minutes (5 to 15 minutes typically) to present to the audience, and share two main things:

    • Business plan: this should be similar to the quick elevator pitch or investment deck as if the company were pitching seed, angel or VC investors.  It is not intended to be an exhaustive fifty page opus in Word, but a quick summary presentation around:
      • Team
      • Market/Problem
      • Solution/Value proposition
      • Competition
      • Business model
      • Launch/financing plans
    • Demo of their actual product: ideally there will be a live product demo shared at Demo Day.  Think of it as a show & tell from your elementary school days, but in reverse.  At Demo Day – you typically tell first what you’re working on, but then you should follow-up and show.  Most tech investors (VCs primarily, but also super-seed and super-angel investors) typically won’t invest with just only a business plan, formally in Powerpoint or written on the proverbial cocktail napkin.  Proof of not just a business opportunity, but in product development and traction typically are table-stakes these days when a start-up is raising a serious round of financing (loosely speaking, anything above/over $150 – $200k).  If a live demo can’t be shown, at least a staged demo should be provided so people can get an appreciation of what the technology and product looks and feels like from a design, UI/UX perspective.  If neither a live or staged demo can be shared, some proof that there isn’t a significant technical and engineering hurdle can help assuage investors.  Or in other words, some testimony that the “D” associated with R&D can be completed.  It’s easy to tell a story and present a business case, but if you’re planning on raising more financing to support your company, build a team, and launch and develop a robust product, investors will want assurance that there isn’t technical risk (i.e. is it theoretically possible) risk or engineering risk (i.e. it’s not just theoretically possible, but this team or resources assembled can make what is theoretically possible into reality in a given timeframe with finite resources).   Usually for popular tech accelerators, Demo Day is a frothy period of time where investors and journalists alike attempt to woo the hottest start-ups and build exclusive relationships, particularly in sexy verticals such as (for now) “social” or “deals” or “photo or video sharing”.   It can be a long day for start-ups, as they prepare and rehearse their Demo but also longer story to be shared with the outside world, but it should be a celebration and a public announcement that they’ve made it through the program, and are ready to take on the world…. And who knows, perhaps raise a Series A(wesome).

    While Demo Day typically marks the end of typical accelerator programs, DDD is slightly different in that it is primarily a challenge first, and then an incubator second.  The challenge doesn’t stop on Thursday 9/15 at the DDD Demo Day in NYC.  Judges at Demo Day will pick two finalists from the five current semi-finalists who will then each receive an additional $10,000 to help pilot their prototypes in community uptake exercises in October.  This will be a great opportunity for the finalist companies to not just talk the talk, but walk the walk in terms of actual live implementation of their product or service in the field so that they can continue iterating and enhancing their value proposition.  A final challenge winner will be selected after the community exercises are conducted and receive the $100,000 final grand prize in November to further accelerate their company’s growth.  They will also have an opportunity to further incubate at the Rock Health health technology app accelerator for a month.   I am sure I speak for not just myself, but all the DDD mentors in that we are impressed in how much has been accomplished in a short period of time, and eagerly await not just Demo Day this week, but the further development of several health tech companies this fall.